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General NPI Number Information
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NPI Number | 1407855802
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Entity Type | Individual
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Provider Name | GEOFFREY C CLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 13861 OLIO RD
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City | FISHERS
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State | IN
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Zip | 46037-3487
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Country | US
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Telephone | 317-338-7136
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Fax | 317-338-6359
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Provider Business Mailing Address
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Address Line | 3926 NEW VISION DR
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City | FORT WAYNE
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State | IN
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Zip | 46845-1712
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Country | US
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Telephone | 260-266-8210
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Fax | 260-458-5636
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01057955A
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License Number State | IN
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