Individual
DR. AMY J. ODOM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
800 E COLUMBIA ST, MASON, MI 48854-1381
(517) 244-8940
(517) 244-8941
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-6253
(517) 364-6208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101015398
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0853311285
BCBS INDIVIDUAL PIN
MI
05
—
4715270
—
MI
05
—
4767919
—
MI
05
—
4767955
—
MI
05
—
4780643
—
MI
Enumeration date
06/20/2006
Last updated
07/08/2007
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