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Individual

DR. LANNY ODIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 N CHENEY ST, TAYLORVILLE, IL 62568-1139
(217) 777-2020
(217) 777-2023
Mailing address
500 N CHENEY ST, TAYLORVILLE, IL 62568-1139
(217) 777-2020
(217) 777-2023

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
IL
207W00000X
Ophthalmology Physician
Primary
036077639
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
180031357
RAILROAD MEDICARE
IL
Enumeration date
05/04/2006
Last updated
06/18/2020
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