Individual
ANDREW WILLIAM ODEGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3780 EISENHOWER PKWY, MACON, GA 31206-0800
(478) 633-5500
Mailing address
3780 EISENHOWER PKWY, MACON, GA 31206-0800
(478) 633-5500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12178
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/23/2020
Last updated
08/12/2021
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