Individual
JOHN SCOT ODLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1800 BIRMINGHAM AVE, JASPER, AL 35501-5461
(205) 384-4474
(205) 384-4428
Mailing address
1800 BIRMINGHAM AVE, JASPER, AL 35501-5461
(205) 384-4474
(205) 384-4428
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
462
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157
ALABAMA LICENSE #
AL
01
—
480034067
RAILROAD MEDICARE
AL
01
—
76296
BC/BS
AL
Enumeration date
11/01/2006
Last updated
12/04/2012
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