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NPI Code Detail

MEDICARE: DR. CYNTHIA L GEOCARIS M.D.

MEDICARE: DR. CYNTHIA L GEOCARIS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician38001WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265435853
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CYNTHIA L GEOCARIS M.D.
Provider Business Mailing Address
First Line : 100 THEDA CLARK MEDICAL PLZ
Second Line : STE 400
City : NEENAH
State : WI
Zip : 54956-2763
Country : US
Telephone Number : 920-725-4527
Fax Number : 920-405-5388
Provider Business Practice Location Address
First Line : 2845 GREENBRIER RD
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-6519
Country : US
Telephone Number : 920-288-8250
Fax Number : 920-288-8255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 01/31/2019

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