Individual
ODELL JOSEPH DEAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2516 BROADMOOR BLVD, MONROE, LA 71201-2988
(318) 807-1390
(318) 807-1394
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD.017252
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1362352
—
LA
Enumeration date
02/14/2007
Last updated
09/23/2016
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