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:
Health care specialties
| Specialty | Code | License # | 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 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407855802 | NPPES |
| Indiana | MEDICAID | 200446790 | |
| Indiana | Other | 000000595614 | |
| Indiana | Other | 000000512001 | |
| Indiana | MEDICAID | 200446790A |
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