Organization
TERRY W ODOM PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY W ODOM M.D. (M.D. -OWNER)
(662) 256-9391
Entity
Organization
Contact information
Practice address
702 EARL FRYE BLVD, AMORY, MS 38821-9403
(662) 256-9391
(662) 256-4307
Mailing address
702 EARL FRYE BLVD, AMORY, MS 38821-9403
(662) 256-9391
(662) 256-4307
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06136862
—
MS
Enumeration date
09/21/2006
Last updated
06/08/2015
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