Basic Information
| Provider Information | |||||||||
| NPI: | 1043834583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAFRI | ||||||||
| FirstName: | SYED MUHAMMAD | ||||||||
| MiddleName: | FARULEET AOUN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1105 E 32ND ST STE 2 | ||||||||
| Address2: | |||||||||
| City: | JOPLIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 648042876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4173477603 | ||||||||
| FaxNumber: | 4173479810 | ||||||||
| Practice Location | |||||||||
| Address1: | 932 E 34TH ST | ||||||||
| Address2: | |||||||||
| City: | JOPLIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 648043932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4173477603 | ||||||||
| FaxNumber: | 4173479810 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2020 | ||||||||
| LastUpdateDate: | 06/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 2020013863 | MO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.