O'Dea, Douglas Lawrence

O'Dea, Douglas Lawrence is an individual health care provider with primary practice located at 7378 Yale Rd , Bartlett TN 38133-3604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. O'Dea, Douglas Lawrence can be contacted via phone (901) 387-0193.

Contact Information

Primary practice address
7378 Yale Rd Bartlett TN 38133-3604
Phone: (901) 387-0193
Fax: (901) 387-0796
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD0000018194 Tennessee

Profile Details

NPI number 1316974132
LBN Legal business name O'Dea, Douglas Lawrence
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Oct 31st, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316974132 NPPES
Tennessee Other 0108564 BLUECROSS OF TENNESSEE
Tennessee MEDICAID 3027190 BLUECROSS OF TENNESSEE

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