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Individual

KENNETH ODINET

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 BEAULLIEU DR, BUILDING 6, LAFAYETTE, LA 70508-7230
(337) 234-8648
(337) 233-0244
Mailing address
200 BEAULLIEU DR, BUILDING 6, LAFAYETTE, LA 70508-7230
(337) 234-8648
(337) 233-0244

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
MD019937
LA
208200000X
Plastic Surgery Physician
Primary
MD019937
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1388050
LA
Enumeration date
11/18/2005
Last updated
04/29/2011
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