Provider Demographics
NPI:1760454086
Name:OFORI, JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:OFORI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 N REYNOLDS RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-2068
Mailing Address - Country:US
Mailing Address - Phone:419-578-2020
Mailing Address - Fax:419-539-6323
Practice Address - Street 1:2865 N REYNOLDS RD
Practice Address - Street 2:SUITE 170
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-2068
Practice Address - Country:US
Practice Address - Phone:419-578-2020
Practice Address - Fax:419-539-6323
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350460310207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4045750OtherAETNA
OH016147OtherONE HEALTH PLAN
OH044181946OtherTRICARE
OH311550308018OtherCIGNA
OH220165OtherSELECTCARE
OH23895OtherNATIONWIDE HEALTH PLANS
OH000000121693OtherANTHEM
OH00110OtherPARAMOUNT
OH1183130001OtherADMINASTAR
MI3441519Medicaid
OH0458928Medicaid
OH0800724OtherUNITED HEALTH CARE
OH600668OtherFAMILY HEALTH PLAN
OHD31226Medicare UPIN
OH220165OtherSELECTCARE
OH23895OtherNATIONWIDE HEALTH PLANS