Provider Demographics
NPI:1518270032
Name:SCHROEDER, JEFFREY MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 BAPTISTE DR STE A
Mailing Address - Street 2:
Mailing Address - City:PAOLA
Mailing Address - State:KS
Mailing Address - Zip Code:66071-1888
Mailing Address - Country:US
Mailing Address - Phone:913-294-2305
Mailing Address - Fax:913-294-3144
Practice Address - Street 1:1401 BAPTISTE DR STE A
Practice Address - Street 2:
Practice Address - City:PAOLA
Practice Address - State:KS
Practice Address - Zip Code:66071-1888
Practice Address - Country:US
Practice Address - Phone:913-294-2305
Practice Address - Fax:913-294-3144
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-01396363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical