Odom, Terry William

Odom, Terry William is an individual health care provider with primary practice located at 702 Earl Frye Blvd , Amory MS 38821-9403. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Odom, Terry William can be contacted via phone (662) 256-9391.

Contact Information

Primary practice address
702 Earl Frye Blvd Amory MS 38821-9403
Fax: (662) 256-4307
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 07566 Mississippi

Profile Details

NPI number 1093814980
LBN Legal business name Odom, Terry William
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Jun 10th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093814980 NPPES
Mississippi MEDICAID 00015694

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