MEDICARE: DR. PAUL CHARLES GEIMER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	1509	AZ

General Provider Information

NPI Number	:	1417921859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL CHARLES GEIMER D.O.

Provider Business Mailing Address
First Line	:	2700 N 3RD STREET
Second Line	:	SUITE # 2005
City	:	PHOENIX
State	:	AZ
Zip	:	85004
Country	:	US
Telephone Number	:	602-254-6515
Fax Number	:	602-254-7971

Provider Business Practice Location Address
First Line	:	2700 N 3RD ST
Second Line	:	SUITE # 2005
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1129
Country	:	US
Telephone Number	:	602-254-6515
Fax Number	:	602-254-7971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	05/24/2011

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