Organization
DR. MARK O'DANIEL & ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BARNARD O'DANIEL D.O. (OWNER)
(252) 937-8222
Entity
Organization
Contact information
Practice address
3031 ZEBULON RD, ROCKY MOUNT, NC 27804-2422
(252) 937-8222
(252) 937-6622
Mailing address
3031 ZEBULON RD, ROCKY MOUNT, NC 27804-2422
(252) 937-8222
(252) 937-6622
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
9700116
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018TJ
BLUE CROSS BLUE SHIELD
NC
01
—
135V6
BLUE CROSS BLUE SHIELD
NC
05
—
5903546
—
NC
05
—
5903560
—
NC
05
—
6006055
—
NC
05
—
89135V6
—
NC
Enumeration date
07/11/2007
Last updated
02/11/2008
Update your record
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