Individual
DR. JOHN ANDREW ODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME70692
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31599
BLUECROSS/BLUESHIELD
FL
01
—
780000637
RAILROAD MEDICARE
FL
Enumeration date
10/04/2005
Last updated
11/06/2012
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