Provider Demographics
NPI:1427167576
Name:JOFTUS, MORRIS (MD)
Entity type:Individual
Prefix:
First Name:MORRIS
Middle Name:
Last Name:JOFTUS
Suffix:
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 1:222 S. WOODS MILL ROAD
Mailing Address - Street 2:SUITE 706 NORTH
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63107-3625
Mailing Address - Country:US
Mailing Address - Phone:314-205-6050
Mailing Address - Fax:314-434-5939
Practice Address - Street 1:5701 DELMAR BLVD.
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63311-2617
Practice Address - Country:US
Practice Address - Phone:314-367-7848
Practice Address - Fax:314-367-2985
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201417532Medicaid
MO201417532Medicaid
MO004012630Medicare ID - Type Unspecified