Provider Demographics
NPI:1073570958
Name:ESCH, PETER A (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:A
Last Name:ESCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL VALLEY STATION, LLC
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0329
Mailing Address - Fax:502-588-0326
Practice Address - Street 1:215 CENTRAL AVE STE 100
Practice Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL VALLEY STATION, LLC
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-1450
Practice Address - Country:US
Practice Address - Phone:502-588-8720
Practice Address - Fax:502-588-8721
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2016-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35040680E207R00000X
KY45561207RG0300X, 207R00000X
OH40680207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0351588Medicaid
OHA75834Medicare UPIN
OHES7349411Medicare PIN