Individual
OSAYAWE NOSAYABA ODEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-8154
(731) 541-6068
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-8697
(731) 422-5743
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
54045
KY
207R00000X
Internal Medicine Physician
Primary
41414
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3815661
—
TN
Enumeration date
07/13/2006
Last updated
11/02/2020
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