Individual
CAITLIN ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 MEDICAL CENTER CIR, MAYFIELD, KY 42066-1194
(270) 251-4527
Mailing address
504 E COLLEGE ST, MAYFIELD, KY 42066-2814
(734) 478-9611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107229
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01204898
R&R MEDICARE
FL
Enumeration date
05/20/2013
Last updated
09/28/2023
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