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General NPI Number Information
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NPI Number | 1700036944
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Entity Type | Individual
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Provider Name | ROBERT T. GIESE PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/24/2008
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905-0001
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Country | US
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Telephone | 507-284-2511
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Fax |
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Provider Business Mailing Address
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Address Line | 40 1ST ST SE
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City | WAUKON
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State | IA
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Zip | 52172-2022
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Country | US
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Telephone | 563-568-3411
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Fax | 563-568-6139
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10500
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1200
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 095520
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License Number State | IA
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