DR. THOMAS G. O'DANIEL M.D. NPI 1871585018

NPI Information

NPI: 1871585018
Provider Name: DR. THOMAS G. O'DANIEL, M.D.
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
222 S 1ST ST
SUITE 100
LOUISVILLE, KY
ZIP 40202
Phone: (502) 584-1109
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DR. Thomas G. O'daniel, M.D. is a plastic and reconstructive surgery surgery in Louisville, KY. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Thomas G. O'daniel, M.D. NPI is 1871585018. 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:

222 S 1ST ST
SUITE 100
LOUISVILLE, KY
ZIP 40202-350
Phone: (502) 584-1109
Fax: (502) 589-6882

The NPI 1871585018 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/15/2005 and was last updated on 4/4/2016.

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	2086S0122X	Surgery	Plastic and Reconstructive Surgery	24070	KENTUCKY	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	000000219660	OTHER	KENTUCKY	ANTHEM PIN
2	KY0057799	OTHER	KENTUCKY	TRICARE
3	1058697	OTHER	KENTUCKY	PASSPORT PIN
4	KY1118	OTHER	KENTUCKY	HEALTHNET PIN
5	64240708	MEDICAID	KENTUCKY
6	1918001	MEDICARE PIN	KENTUCKY
7	002	OTHER	KENTUCKY	CIGNA
8	667357	OTHER	KENTUCKY	HEALTHLINK
9	C72177	MEDICARE UPIN	KENTUCKY
10	240007956	MEDICARE ID-TYPE UNSPECIFIED	KENTUCKY	RAILROAD MEDICARE ID
11	100033340A	MEDICAID	INDIANA

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: 11/14/2023

NPI Synchronization or Removal

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