Individual
BENJAMIN ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3104 BLUE LAKE DR STE 110, VESTAVIA, AL 35243-2372
(205) 977-1949
(205) 977-1933
Mailing address
406 N ELM ST, MOUNT PLEASANT, TN 38474-1217
(205) 441-2996
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-142308
AL
Other
Enumeration date
03/20/2020
Last updated
03/20/2020
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