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
Phone: (662) 256-9391
Fax: (662) 256-4307
Website:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093814980 | NPPES |
| Mississippi | MEDICAID | 00015694 |
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