Basic Information
Provider Information
NPI: 1295963478
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SANCHEZ
FirstName: JESSICA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 901 E 104TH ST
Address2: MAILSTOP 400
City: KANSAS CITY
State: MO
PostalCode: 641316413
CountryCode: US
TelephoneNumber: 8165027117
FaxNumber: 8169329670
Practice Location
Address1: 4401 WORNALL RD
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641113220
CountryCode: US
TelephoneNumber: 8169322995
FaxNumber: 8169323939
Other Information
ProviderEnumerationDate: 06/26/2009
LastUpdateDate: 11/14/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XMD038129DCN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X0101247536VAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X2011018388MOY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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