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General NPI Number Information
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NPI Number | 1558450742
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Entity Type | Individual
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Provider Name | ERIC SCOTT GIESE O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 16573 W BELL RD
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City | SURPRISE
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State | AZ
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Zip | 85374-9892
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Country | US
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Telephone | 623-584-0852
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Fax |
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Provider Business Mailing Address
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Address Line | 8332 W BAJADA RD
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City | PEORIA
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State | AZ
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Zip | 85383-3880
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Country | US
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Telephone | 714-504-8545
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1471
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License Number State | AZ
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