Individual
MARK ERNST GIESECKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
463 SOUTH LAKE POWELL BLVD, PAGE, AZ 86040-0790
(928) 645-5113
(928) 645-3254
Mailing address
420 W HAVASUPAI RD, FLAGSTAFF, AZ 86001-1510
(928) 779-5419
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
19591
AZ
Other
Enumeration date
11/04/2005
Last updated
07/08/2007
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