Individual
BENNETT GRAHAM ODEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 6TH AVE, DES MOINES, IA 50314-2613
(515) 643-2682
(515) 643-5802
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-2682
(515) 643-5802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R-12268
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/27/2020
Last updated
06/21/2021
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