Healthcare Provider Details

I. General information

NPI: 1346850559
Provider Name (Legal Business Name): JAFAR OHIOKPEHAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13013 FULLER AVE STE A
GRANDVIEW MO
64030-2687
US

IV. Provider business mailing address

3 SAINT ELIZABETH BLVD STE 4000
O FALLON IL
62269-1284
US

V. Phone/Fax

Practice location:
  • Phone: 816-509-6694
  • Fax:
Mailing address:
  • Phone: 618-233-5480
  • Fax: 844-458-7916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number2023016340
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: