Keith J. Odegard MD

NPI 1083609614 - Orthopaedic Surgery - 207X00000X

NPI Details
NPI 1083609614
Gender Male
Enumeration Date 09/20/2005
Last Updated 10/21/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
12855 NORTH FORTY DRIVE
SUITE 125
ST. LOUIS MO, 63141, US
Phone (314) 966-0111
Fax (314) 966-1023
Business Location
12813 FLUSHING MEADOWS DRIVE
SUITE 210
ST. LOUIS MO, 63131, US
Phone (314) 966-0111
Fax (314) 966-1023
Toxanomy
Taxonomy Code 207X00000X
License State Missouri
License Number 2004027795
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According to our database, Keith J. Odegard MD NPI is 1083609614, taxonomy code is 207X00000X and license number is 2004027795, license state is located at Missouri. Keith J. Odegard MD physically located at 12855 North Forty Drive, St. Louis MO, 63141. NPI Number Keith J. Odegard MD has the Individual type.

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1083609614 NPI number is provided on an as is basis without warranty of any kind. 1083609614 is maintained by the National Plan & Provider Enumeration System. The contents of Keith J. Odegard MD are for informational purposes only.