Individual
GEOFFREY LYLE ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15790 PAUL VEGA MD DR, FINANCE DEPARTMENT, HAMMOND, LA 70403-1434
(985) 230-1369
(985) 230-1368
Mailing address
PO BOX 2668, HAMMOND, LA 70404-2668
(985) 230-1369
(985) 230-1368
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD.023178
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07972078
—
MS
05
—
1492418
—
LA
Enumeration date
07/07/2006
Last updated
03/16/2017
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