Provider Demographics
NPI:1629028667
Name:JONES, OLUJOKE R (MD)
Entity Type:Individual
Prefix:
First Name:OLUJOKE
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLUJOKE
Other - Middle Name:
Other - Last Name:BRIMAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 N OAKS PLZ
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63121-2925
Mailing Address - Country:US
Mailing Address - Phone:314-391-9777
Mailing Address - Fax:314-390-5404
Practice Address - Street 1:175 N OAKS PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63121-2925
Practice Address - Country:US
Practice Address - Phone:314-391-9777
Practice Address - Fax:314-390-5404
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA62951207R00000X
ARE-7245208M00000X
OH35.126875208M00000X
MO2005009913207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
717260OtherHEALTHLINK
P00238340OtherRAILROAD MEDICARE
199692OtherBCBS
MO207365909Medicaid
MO1629028667Medicaid
AR161344001Medicaid
MO431560263OtherTRICARE
MOH85067Medicare UPIN
AR161344001Medicaid
935683247Medicare PIN