Provider Demographics
NPI:1194983114
Name:CHO, JENNY GRACE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNY
Middle Name:GRACE
Last Name:CHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:GRACE
Other - Last Name:HAWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7420 SWTIZER
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203
Mailing Address - Country:US
Mailing Address - Phone:913-262-9201
Mailing Address - Fax:913-262-3170
Practice Address - Street 1:7420 SWITZER
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-1239
Practice Address - Country:US
Practice Address - Phone:913-262-9201
Practice Address - Fax:913-262-3170
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064769A2086S0129X
KS04-342162086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30003975440001Medicaid