Provider Demographics
NPI:1669475679
Name:EISENACH, JOSEPH B (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:EISENACH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3800 S WHITNEY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-6739
Mailing Address - Country:US
Mailing Address - Phone:816-478-4887
Mailing Address - Fax:816-478-7222
Practice Address - Street 1:8580 N GREEN HILLS RD STE A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1419
Practice Address - Country:US
Practice Address - Phone:816-478-4887
Practice Address - Fax:816-478-7222
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2025-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO102111207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202763215Medicaid
MO4181062AMedicare PIN
MOE06427Medicare UPIN
MO202763215Medicaid