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Individual
DR. THOMAS G. O'DANIEL JR.
Active
Individual
DR. THOMAS G. O'DANIEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
24070
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000219660
ANTHEM PIN
KY
01
—
002
CIGNA
KY
05
—
100033340A
—
IN
01
—
1058697
PASSPORT PIN
KY
05
—
64240708
—
KY
01
—
667357
HEALTHLINK
KY
01
—
KY0057799
TRICARE
KY
01
—
KY1118
HEALTHNET PIN
KY
Enumeration date
08/15/2005
Last updated
04/04/2016
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