Individual
JOY ODETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
163 BUTNER DR, HOPE, IN 47246-9447
(812) 546-6000
Mailing address
14 TRAFALGAR SQ, TRAFALGAR, IN 46181-9515
(317) 739-4895
(317) 878-2355
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01078300A
IN
207Q00000X
Family Medicine Physician
MD.205074
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19679
—
LA
05
—
300001579
—
IN
Enumeration date
09/17/2008
Last updated
09/27/2024
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