Individual
DR. STEPHEN RAY ODOM II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14 MEDICAL PARK DR, ASHEVILLE, NC 28803-2493
(828) 252-3366
(828) 258-0891
Mailing address
110 FRANCIS ST, LMOB 3A, BOSTON, MA 02215-5501
(617) 632-9786
(617) 632-0886
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
43996
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33452555
—
CO
01
—
840255530039
ROCKY MTN HEALTH PLANS
CO
01
—
P00255737
MEDICARE RAILROAD CARRIER
CO
Enumeration date
12/06/2005
Last updated
05/16/2018
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