Organization
ODESSA ACUTE TRAUMA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JERNBERG MD (ENROLLMENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
500 W 4TH ST, ODESSA, TX 79761-5001
(432) 332-7500
(432) 332-7503
Mailing address
13737 NOEL RD, SUITE 1600, DALLAS, TX 75240-1331
(469) 401-2386
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
Primary
—
—
Other
Enumeration date
02/13/2013
Last updated
01/24/2014
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