Provider Demographics
NPI:1881760684
Name:JESCHKE, ROBERT E (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:JESCHKE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:300 HOSPITAL ROAD
Mailing Address - Street 2:EISENHOWER ARMY MEDICAL CENTER, ATTN - CREDENTIALS
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5650
Mailing Address - Country:US
Mailing Address - Phone:706-787-2720
Mailing Address - Fax:706-787-8176
Practice Address - Street 1:300 HOSPITAL ROAD
Practice Address - Street 2:EISENHOWER ARMY MEDICAL CENTER, ATTN - CREDENTIALS
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905-5650
Practice Address - Country:US
Practice Address - Phone:706-787-2720
Practice Address - Fax:706-787-8176
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2023-08-25
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Provider Licenses
StateLicense IDTaxonomies
GA64838207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD 000Medicare UPIN