Healthcare Provider Details

I. General information

NPI: 1285194514
Provider Name (Legal Business Name): JOSEPH FRANCIS GEIGER III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 INDUSTRIAL BLVD STE 125
PAOLI PA
19301-1645
US

IV. Provider business mailing address

6 RAFFAELA DR
MALVERN PA
19355-2559
US

V. Phone/Fax

Practice location:
  • Phone: 610-731-7374
  • Fax:
Mailing address:
  • Phone: 610-764-3459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS043936
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: