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Individual

DR. GRANT H GEISSLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3001 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6307
(813) 554-8384
(813) 443-8160
Mailing address
PO BOX 10744, CLEARWATER, FL 33757-8744
(727) 532-0002
(727) 266-4943

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
036078239
IL
2086S0120X
Pediatric Surgery Physician
Primary
ME129728
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019487300
FL
05
036078239
IL
01
1633575
BCBS PROVIDER ID
IL
01
37146364501
ADVOCATE HLTH PARTNERS ID
IL
Enumeration date
12/04/2007
Last updated
03/03/2017
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