Individual
DR. STEPHEN G. ODOM
Active
Individual
DR. STEPHEN G. ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6332
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006264
BLUE CROSS
TN
01
—
2604322
CIGNA
TN
05
—
3156890
—
TN
01
—
44D0307626
CLIA ID NUMBER
—
Enumeration date
06/11/2006
Last updated
07/19/2010
Update your record
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