Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 2003013104 | MO |
Y | 213EG0000X | General Practice | 2003013104 | MO |
NPI | 1003904574 |
---|---|
Provider Name | Dr. Jason Matthew Sanchez |
First Address | Kansas City, MO 64112-2015 |
Second Address | Kansas City, MO 64112-2015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |