Individual
JONATHAN KIRK VASHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807
(417) 269-6583
(417) 269-6573
Mailing address
PO BOX 9007, SPRINGFIELD, MO 65808-9007
(417) 269-6583
(417) 269-6573
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2018011405
MO
207P00000X
Emergency Medicine Physician
R2549
AZ
363A00000X
Physician Assistant
2012006657
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982752085
—
MO
05
—
200058646
—
MO
Enumeration date
01/08/2007
Last updated
04/02/2026
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