Thomas Russell Geisenheimer Jr., D.O.
Family Medicine in Kirksville, MO. Individual provider (NPI-1).
NPI number1104233378
StatusActive
Last updated in NPPESJul 18, 2014
Details
- NPI
- 1104233378
- Entity type
- Individual (NPI-1)
- Name
- Thomas Russell Geisenheimer Jr.
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 18, 2014
- Last updated
- Jul 18, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 2014021962 | MO | Yes |
Practice location
315 S Osteopathy AveKirksville, MO 63501-6401
Phone 660-785-1400
Mailing address
810 Kings Rd Apt 2Kirksville, MO 63501-2571
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