MEDICARE: HEATHER K GEIS MD

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	2084P0804X	Child & Adolescent Psychiatry Physician	15710	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619961885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER K GEIS MD

Provider Business Mailing Address
First Line	:	2816 NW 57TH ST
Second Line	:	104
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7045
Country	:	US
Telephone Number	:	405-848-7882
Fax Number	:	405-848-7818

Provider Business Practice Location Address
First Line	:	1625 GREENBRIAR PL
Second Line	:	#300
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7645
Country	:	US
Telephone Number	:	405-692-4000
Fax Number	:	405-692-4001

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

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	09/19/2023

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