Individual
PROF. WILLIAM BENNETT GEISSLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1410 E WOODROW WILSON AVE, STE D, JACKSON, MS 39216-5114
(601) 984-5144
(601) 815-3027
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5144
(601) 815-3027
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
11169
MS
207XX0801X
Orthopaedic Trauma Physician
11169
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116304
—
MS
01
—
11169
LICENSE
—
05
—
126102
—
AL
05
—
1990728
—
LA
01
—
200014928
RAILROAD MEDICARE
—
01
—
512I200005
MEDICARE PTAN
MS
01
—
P00462205
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/28/2005
Last updated
12/30/2015
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