Healthcare Provider Details

I. General information

NPI: 1255365581
Provider Name (Legal Business Name): RALPH OIKNINE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 S WOODS MILL RD
CHESTERFIELD MO
63017-3625
US

IV. Provider business mailing address

222 S WOODS MILL RD SUITE 410N
CHESTERFIELD MO
63017-3625
US

V. Phone/Fax

Practice location:
  • Phone: 314-469-6224
  • Fax: 314-469-0744
Mailing address:
  • Phone: 314-469-6224
  • Fax: 314-469-0744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number214732
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: