Cly, Geoffrey C

Cly, Geoffrey C is an individual health care provider with primary practice located at 11123 Parkview Plaza Dr Suite 101, Fort Wayne IN 46845-1707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Cly, Geoffrey C can be contacted via phone (260) 422-7455.

Contact Information

Primary practice address
11123 Parkview Plaza Dr Suite 101 Fort Wayne IN 46845-1707
Phone: (260) 422-7455
Fax: (260) 424-9356
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01057955A Indiana

Profile Details

NPI number 1407855802
LBN Legal business name Cly, Geoffrey C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Apr 12th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407855802 NPPES
Indiana MEDICAID 200446790
Indiana Other 000000595614
Indiana Other 000000512001
Indiana MEDICAID 200446790A

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