Organization
JASPER PODIATRY CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S ODLE DPM (CHAIRMAN)
(205) 924-4474
Entity
Organization
Contact information
Practice address
1800 BIRMINGHAM AVE, JASPER, AL 35501-5461
(205) 384-4474
(205) 384-4428
Mailing address
804 20TH AVE E, JASPER, AL 35501-4024
(120) 538-4447
(205) 384-4588
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
157
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051176296
BLUE CROSS AND BLUE SHIELD OF ALABAMA
AL
01
—
157
LICENSE NUMBER
AL
01
—
480034067
RAILROAD MEDICARE
AL
01
—
U58040
UPIN
AL
Enumeration date
09/06/2007
Last updated
10/06/2023
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