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Individual

DR. STEPHEN G. ODOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1005 N TENNESSEE BLVD, MURFREESBORO, TN 37130-2653
(615) 893-1615
(615) 893-2747
Mailing address
1005 N TENNESSEE BLVD, MURFREESBORO, TN 37130-2653
(615) 893-1615
(615) 893-2747

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
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