Provider Demographics
NPI:1194779736
Name:GESSNER, GENE STEBBINS (MD)
Entity type:Individual
Prefix:MR
First Name:GENE
Middle Name:STEBBINS
Last Name:GESSNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2400
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50704-2400
Mailing Address - Country:US
Mailing Address - Phone:319-232-6000
Mailing Address - Fax:319-232-0722
Practice Address - Street 1:210 4TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-1898
Practice Address - Country:US
Practice Address - Phone:641-236-2338
Practice Address - Fax:641-236-2427
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28333207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1106001Medicare PIN
E98772Medicare UPIN
IAI16150009Medicare PIN