CECIL DOUGLAS ODOM M.D. NPI 1093815474

NPI Information

  • NPI: 1093815474
  • Provider Name: CECIL DOUGLAS ODOM, M.D.
  • Classification: Obstetrics & Gynecology - 207VG0400X
  • Specialization: Gynecology
  • Entity Type: Individual
  • Address: 1020 RIVER OAKS DRIVE,
    STE 310
    JACKSON, MS
    ZIP 39232
  • Phone: (601) 932-5006

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NPI Details

Cecil Douglas Odom, M.D. is a gynecology obstetrics gynecology in Jackson, MS. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee Cecil Douglas Odom, M.D. NPI is 1093815474. 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:

1020 RIVER OAKS DRIVE,
STE 310
JACKSON, MS
ZIP 39232
Phone: (601) 932-5006
Fax: (601) 932-4548

The enumeration date for this NPI number is 9/25/2006 and was last updated on 10/18/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecology05821MISSISSIPPIYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D89911MEDICARE UPINMISSISSIPPI
200017818MEDICAIDMISSISSIPPI
3160000689MEDICARE ID-TYPE UNSPECIFIEDMISSISSIPPI

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: 11/21/2025

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