Provider Demographics
NPI:1891175527
Name:ESHCOL, JENNA BETH KAWASE (MD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:BETH KAWASE
Last Name:ESHCOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 741331
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1331
Mailing Address - Country:US
Mailing Address - Phone:913-469-0503
Mailing Address - Fax:913-338-1311
Practice Address - Street 1:15101 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:KS
Practice Address - Zip Code:66223-3154
Practice Address - Country:US
Practice Address - Phone:913-681-8866
Practice Address - Fax:913-338-1311
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2020-08-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAR-10333207Q00000X
KS04-40995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine