Carol M. Odegaard, Md, Pc

NPI 1114294972 - Family Medicine - 207Q00000X

NPI Details
NPI 1114294972
Enumeration Date 11/22/2011
Last Updated 08/15/2012
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name CAROL M. CAROL
Position CEO/PHYSICIAN
Phone (678) 752-0555
Fax (678) 752-0556
Practice Location
261 BROOKWOOD AVE
JACKSON GA, 30233-1460, US
Phone (678) 752-0555
Fax (678) 752-0556
Business Location
261 BROOKWOOD AVE
JACKSON GA, 30233-1460, US
Phone (678) 752-0555
Fax (678) 752-0556
Toxanomy
Taxonomy Code 207Q00000X
License State Georgia
License Number 040495
Remove 1114294972 NPI Number
 

According to our database, Carol M. Odegaard, Md, Pc NPI is 1114294972, taxonomy code is 207Q00000X and license number is 040495, license state is located at Georgia. Carol M. Odegaard, Md, Pc physically located at 261 Brookwood Ave, Jackson GA, 30233-1460. NPI Number 1033115704 has the healthcare provider type.

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1114294972 NPI number is provided on an as is basis without warranty of any kind. 1114294972 is maintained by the National Plan & Provider Enumeration System. The contents of Carol M. Odegaard, Md, Pc are for informational purposes only.