Provider Demographics
NPI:1952510604
Name:GEESLIN, JOHN LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LOUIS
Last Name:GEESLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-3740
Mailing Address - Country:US
Mailing Address - Phone:352-383-8976
Mailing Address - Fax:
Practice Address - Street 1:970 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-3740
Practice Address - Country:US
Practice Address - Phone:352-383-8976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19637174400000X, 207PH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine