Individual
BRETT C ODUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
240 MEDICAL PARK BLVD, STE 3600, BRISTOL, TN 37620-7346
(423) 990-2400
(423) 990-2405
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101232193
VA
207Q00000X
Family Medicine Physician
Primary
MD 37808
TN
208M00000X
Hospitalist Physician
37808
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3888335
—
TN
Enumeration date
06/09/2005
Last updated
08/17/2011
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