Provider Demographics
NPI:1891790788
Name:O'KEEFE, JOHN JOSEPH III (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:O'KEEFE
Suffix:III
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 1:12818 TESSON FERRY RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2945
Mailing Address - Country:US
Mailing Address - Phone:314-849-5665
Mailing Address - Fax:314-849-0274
Practice Address - Street 1:12818 TESSON FERRY RD STE 102
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2945
Practice Address - Country:US
Practice Address - Phone:314-849-5665
Practice Address - Fax:314-849-0274
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR74912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO130008428OtherRAILROAD MEDICARE
23276OtherBLUE CROSS BLUE SHIELD
MOR7491Medicaid
MOR7491Medicaid
MO000001552Medicare PIN