Individual
JASON B O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1005 E CHEVES ST, FLORENCE, SC 29506-2707
(843) 777-7900
(843) 777-7102
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-7092
(843) 777-7102
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
27197
SC
207X00000X
Orthopaedic Surgery Physician
ME103720
FL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
27197
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00052500
—
FL
05
—
21464
—
LA
01
—
23163
BCBS
FL
05
—
271976
—
SC
01
—
329791
AVMED
FL
01
—
9234356
AETNA
FL
01
—
9250826
CIGNA
FL
Enumeration date
05/22/2007
Last updated
02/15/2021
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