Provider Demographics
NPI:1003895236
Name:OJILE, JOSEPH M (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:OJILE
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:11222 TESSON FERRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6963
Mailing Address - Country:US
Mailing Address - Phone:314-849-1500
Mailing Address - Fax:314-849-8789
Practice Address - Street 1:11200 TESSON FERRY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-6922
Practice Address - Country:US
Practice Address - Phone:314-849-1500
Practice Address - Fax:314-849-8789
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2010-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR3F72207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202899316Medicaid
MOE56844Medicare UPIN
MO000000802Medicare ID - Type Unspecified