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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
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