Individual
DR. KRESLYN BARRON ODUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
420 W CHERRY ST, JESUP, GA 31545-1435
(478) 553-0007
(478) 552-6619
Mailing address
420 W CHERRY ST, JESUP, GA 31545-1435
(478) 553-0007
(478) 552-6619
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002242
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11620798
CAQH
GA
05
—
709627117D
—
GA
Enumeration date
04/06/2006
Last updated
03/07/2023
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