Individual
MRS. KATHRYN FOLKNER ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
275 COLLIER RD NW STE 450, ATLANTA, GA 30309-1748
(404) 351-8873
(404) 355-6165
Mailing address
275 COLLIER RD NW STE 450, ATLANTA, GA 30309-1748
(404) 351-8873
(404) 355-6165
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110007579
VA
363AM0700X
Medical Physician Assistant
0110007579
VA
363AM0700X
Medical Physician Assistant
Primary
8040
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053865956
—
VA
Enumeration date
08/09/2016
Last updated
03/22/2024
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