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DR. TERRY WILLIAM ODOM M.D. NPI 1093814980


NPI Information

NPI: 1093814980
Provider Name: DR. TERRY WILLIAM ODOM, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 25D2094499

Address:
702 EARL FRYE BLVD
AMORY, MS
ZIP 38821
Phone: (662) 256-9391
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DR. Terry William Odom, M.D. is a pediatrics in Amory, MS. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Terry William Odom, M.D. NPI is 1093814980. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

702 EARL FRYE BLVD
AMORY, MS
ZIP 38821-403
Phone: (662) 256-9391
Fax: (662) 256-4307

The CLIA number assigned to this NPI record is 25D2094499 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 6/10/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics07566MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F01954MEDICARE UPINMISSISSIPPI
200015694MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.