Provider Demographics
NPI:1396923397
Name:GEYER, JACOB LEWIS
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:LEWIS
Last Name:GEYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 BOMBAY AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3470
Mailing Address - Country:US
Mailing Address - Phone:614-523-3657
Mailing Address - Fax:
Practice Address - Street 1:237 BOMBAY AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3470
Practice Address - Country:US
Practice Address - Phone:614-523-3657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program