DR. JERRY DEANIE ODOM D.C. NPI 1154546240

NPI Information

NPI: 1154546240
Provider Name: DR. JERRY DEANIE ODOM, D.C.
Classification: Chiropractor - 111N00000X
Entity Type: Individual
Address:
147 PENDLETON ST NW
AIKEN, SC
ZIP 29801
Phone: (803) 646-4381
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DR. Jerry Deanie Odom, D.C. is a chiropractor in Aiken, SC. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DR. Jerry Deanie Odom, D.C. NPI is 1154546240. 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:

147 PENDLETON ST NW
AIKEN, SC
ZIP 29801-859
Phone: (803) 646-4381

The enumeration date for this NPI number is 4/16/2007 and was last updated on 8/26/2010.

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
1	111N00000X	Chiropractor		038-010666	ILLINOIS	No
2	111N00000X	Chiropractor		3522	SOUTH CAROLINA	Yes

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
1	K45427	MEDICARE UPIN

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: 5/5/2024

NPI Synchronization or Removal

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