Healthcare Provider Details

I. General information

NPI: 1396787263
Provider Name (Legal Business Name): DAVID R. GELLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 TERRA CROSSING BLVD STE 375
LOUISVILLE KY
40245-5395
US

IV. Provider business mailing address

3920 DUTCHMANS LN STE 308
LOUISVILLE KY
40207-4702
US

V. Phone/Fax

Practice location:
  • Phone: 502-893-7151
  • Fax: 502-893-7020
Mailing address:
  • Phone: 502-893-7151
  • Fax: 502-893-7020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number36536
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: