MEDICARE: DR. IAN STOREY GEIS D.O.

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	2084P0800X	Psychiatry Physician	DR.0062431	CO

General Provider Information

NPI Number	:	1801158449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IAN STOREY GEIS D.O.

Provider Business Mailing Address
First Line	:	2860 S CIRCLE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4113
Country	:	US
Telephone Number	:	719-540-2100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 S CIRCLE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4113
Country	:	US
Telephone Number	:	719-540-2100
Fax Number	:

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

Provider Enumeration Date	:	06/11/2012
Last Update Date	:	10/13/2020

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