Individual
JINY MATHEW OLICKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1009 W SAINT MAARTENS DR STE F, SAINT JOSEPH, MO 64506-2990
(816) 232-8145
(816) 279-1840
Mailing address
1009 W SAINT MAARTENS DR STE F, SAINT JOSEPH, MO 64506-2990
(816) 232-8145
(816) 279-1840
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TRN20587
FL
207RN0300X
Nephrology Physician
Primary
2018038324
MO
Other
Enumeration date
10/02/2015
Last updated
08/09/2019
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