Provider Demographics
NPI:1649261926
Name:GIESLER, JOHN HAROLD (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HAROLD
Last Name:GIESLER
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 1:255 PROFESSIONAL CT
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-2531
Mailing Address - Country:US
Mailing Address - Phone:770-337-8424
Mailing Address - Fax:
Practice Address - Street 1:255 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2531
Practice Address - Country:US
Practice Address - Phone:770-997-8424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA358822085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA920000946OtherRAILROAD MEDICARE
GA300037175OtherRAILROAD MEDICARE
GA2405450OtherUNITED HEALTHCARE
GA920000948OtherRAILROAD MEDICARE
GA00582887CMedicaid
GA00582887BMedicaid
GA2403450OtherUNITED HEALTHCARE
GA450638OtherBC/BS GA
GA00582887DMedicaid
GA45062OtherBC/BS GA
GA450641OtherBC/BS GA
GA480640OtherBC/BS GA
GA920000950OtherRAILROAD MEDICARE
GA2402350OtherUNITED HEALTHCARE
GA45062OtherBC/BS GA
GA480640OtherBC/BS GA
GA92BDBDCMedicare ID - Type Unspecified
GA92BDBCZMedicare ID - Type Unspecified
GA00582887BMedicaid
GA450638OtherBC/BS GA