Provider Demographics
NPI:1285727727
Name:FASIPE, FRANCISCA REMILEKUN (MD)
Entity type:Individual
Prefix:DR
First Name:FRANCISCA
Middle Name:REMILEKUN
Last Name:FASIPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FRANCISCA
Other - Middle Name:REMILEKUN
Other - Last Name:TAIWO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 505164
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-5164
Mailing Address - Country:US
Mailing Address - Phone:417-829-4620
Mailing Address - Fax:417-829-4316
Practice Address - Street 1:1235 E CHEROKEE ST
Practice Address - Street 2:ST JUDE - MERCY AFFILIATE CLINIC
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2203
Practice Address - Country:US
Practice Address - Phone:417-820-5833
Practice Address - Fax:417-820-8018
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0765482080P0207X
MO20090159512080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR178701001Medicaid
NJ0023051Medicaid
MO209373505OtherHEALTHNET LEGACY
NJ3416925OtherAETNA
NJP3165305OtherOXFORD
NJ010005845OtherAMERICHOICE
MO1285727727Medicaid
NJ2521640OtherUNIVERSITY HEALTH PLAN
NJ3K5979OtherHEALTHNET
NJ7778481OtherCIGNA
NJ1635912OtherAMERIHEALTH PPO/PA BS
NJ2310999000OtherAMERIHEALTH/KEYSTONE/IBC
NJ60004100OtherHORIZON NJ HEALTH
431560263OtherTRICARE WEST
MO209373505OtherHEALTHNET LEGACY
NJ60004100OtherHORIZON NJ HEALTH
AR178701001Medicaid