Individual
JOHN N ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3032 E HIGHWAY 76, MULLINS, SC 29574-7396
(843) 292-7331
(843) 292-7324
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 292-7331
(843) 292-7324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16250
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T10501
—
SC
Enumeration date
02/08/2006
Last updated
03/26/2009
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