Individual
DR. TARA L ODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4000 KRESGE WAY, EMERGENCY DEPARTMENT BAPTIST HEALTH LOUISVILLE, LOUISVILLE, KY 40207-4605
(502) 899-7646
(502) 899-7648
Mailing address
PO BOX 6749, LOUISVILLE, KY 40206-0749
(502) 899-7646
(502) 899-7648
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35847
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000786307
ANTHEM BC/BS
KY
05
—
200355490
—
IN
01
—
35847
KY LICENSE
KY
01
—
50042929
PASSPORT
KY
05
—
64042492
—
KY
Enumeration date
09/01/2006
Last updated
03/07/2023
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