Provider Demographics
NPI:1073530697
Name:SCHLACHTER, JEFFREY LEWIS (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LEWIS
Last Name:SCHLACHTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6703 W 131ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-4002
Mailing Address - Country:US
Mailing Address - Phone:816-716-6900
Mailing Address - Fax:913-648-9235
Practice Address - Street 1:6703 W 131ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-4002
Practice Address - Country:US
Practice Address - Phone:816-716-6900
Practice Address - Fax:913-648-9235
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2016-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9779207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO241551423Medicaid
MO241551423Medicaid
MOT424704Medicare ID - Type Unspecified