Provider Demographics
NPI:1952349300
Name:GEISLER, GEORGE LARRY IV (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:LARRY
Last Name:GEISLER
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 S HAZEL AVE
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2500
Mailing Address - Country:US
Mailing Address - Phone:215-891-0662
Mailing Address - Fax:
Practice Address - Street 1:100 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-1008
Practice Address - Country:US
Practice Address - Phone:267-587-0775
Practice Address - Fax:215-710-5861
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010714L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001903187Medicaid
H67407Medicare UPIN