MEDICARE: WILLIAM L. GEISSERT MD

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
1	207R00000X	Internal Medicine Physician	G62194	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1477631372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM L. GEISSERT MD

Provider Business Mailing Address
First Line	:	PO BOX 5193
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93755-5193
Country	:	US
Telephone Number	:	559-304-9039
Fax Number	:	559-229-0511

Provider Business Practice Location Address
First Line	:	4770 W HERNDON AVE # 111
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8401
Country	:	US
Telephone Number	:	559-450-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/17/2016

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