Odum, Brett C

Odum, Brett C is an individual health care provider with primary practice located at 240 Medical Park Blvd Ste 3600, Bristol TN 37620-7346. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Odum, Brett C can be contacted via phone (423) 990-2400.

Contact Information

Primary practice address
240 Medical Park Blvd Ste 3600 Bristol TN 37620-7346
Phone: (423) 990-2400
Fax: (423) 990-2405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101232193 Virginia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD 37808 Tennessee
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 37808 Tennessee

Profile Details

NPI number 1336143163
LBN Legal business name Odum, Brett C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Aug 17th, 2011 - about 15 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 1336143163 NPPES
Tennessee MEDICAID 3888335

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