Individual
DR. MARTY WAYNE ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
490 DUNLOP LN, CLARKSVILLE, TN 37040-5007
(931) 245-7000
Mailing address
PO BOX 3799, CLARKSVILLE, TN 37043-3799
(931) 245-7000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
75415
TN
207R00000X
Internal Medicine Physician
ME82596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266818100
—
FL
01
—
P01109190
R&R MEDICARE
FL
Enumeration date
10/11/2006
Last updated
12/29/2025
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