Healthcare Provider Details

I. General information

NPI: 1922099449
Provider Name (Legal Business Name): BERT E GEER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W 3RD ST
COOKEVILLE TN
38501-2495
US

IV. Provider business mailing address

100 W 3RD ST
COOKEVILLE TN
38501-2495
US

V. Phone/Fax

Practice location:
  • Phone: 931-528-9047
  • Fax: 931-372-0045
Mailing address:
  • Phone: 931-528-9047
  • Fax: 931-372-0045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDO0000001010
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberDO0000001010
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: