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General NPI Number Information
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NPI Number | 1720247257
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Entity Type | Individual
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Provider Name | GEOFFREY JOSEPH ROELANT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 12/17/2021
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Provider Practice Location Address
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Address Line | 719 W HAMILTON AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6968
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Country | US
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Telephone | 715-832-1044
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Fax | 715-832-0520
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Provider Business Mailing Address
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Address Line | 719 W HAMILTON AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6968
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Country | US
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Telephone | 715-832-1044
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Fax | 715-832-0520
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME116971
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 70896-20
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License Number State | WI
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