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General NPI Number Information
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NPI Number | 1265480206
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Entity Type | Individual
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Provider Name | JOHN W GEREN DO
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 210 E WALNUT ST
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City | NICHOLASVILLE
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State | KY
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Zip | 40356-1252
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Country | US
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Telephone | 859-225-4325
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Fax | 859-225-0458
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Provider Business Mailing Address
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Address Line | 1621 WOODS RD
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City | NICHOLASVILLE
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State | KY
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Zip | 40356-8790
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Country | US
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Telephone | 859-619-8295
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 02075
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License Number State | KY
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