DWIGHT O'DELL M.D. LTD. NPI 1639271513

NPI Information

DWIGHT O'DELL, M.D., LTD. is a gynecology obstetrics gynecology in Belleville, IL. DWIGHT O'DELL, M.D., LTD. NPI is 1639271513. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4550 MEMORIAL DR
SUITE 200
BELLEVILLE, IL
ZIP 62226-359
Phone: (618) 233-5998
Fax: (618) 233-6001

The provider's authorized official is Dwight William O'dell .
The authorized official title is President and has the following contact phone number (618) 233-5998.

The enumeration date for this NPI number is 9/2/2006 and was last updated on 10/9/2007.

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:

Other Identifiers

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

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