Provider Demographics
NPI:1255456653
Name:GEIGER, TRACY M (MD)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:M
Last Name:GEIGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:15430 W CAPITOL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-2626
Mailing Address - Country:US
Mailing Address - Phone:262-421-5133
Mailing Address - Fax:262-735-0723
Practice Address - Street 1:15430 W CAPITOL DR STE 100
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-2626
Practice Address - Country:US
Practice Address - Phone:262-421-5133
Practice Address - Fax:262-735-0723
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2024-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI52008207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400195556Medicare PIN