Individual
DR. MATTHEW RICHARD ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1050 NW 8TH AVE STE 20, GAINESVILLE, FL 32601-4998
(352) 379-7900
(352) 379-2971
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME112150
FL
207Q00000X
Family Medicine Physician
ME112150
FL
207Q00000X
Family Medicine Physician
TRN13500
FL
Other
Enumeration date
05/01/2009
Last updated
10/23/2018
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