Odom-Austin, Angela D

Odom-Austin, Angela D is an sole proprietor health care provider with primary practice located at 1140 S Vienna St , Ruston LA 71270-5834. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Odom-Austin, Angela D can be contacted via phone (318) 224-7190.

Contact Information

Primary practice address
1140 S Vienna St Ruston LA 71270-5834
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 0101047120 Virginia

Profile Details

NPI number 1437180072
LBN Legal business name Odom-Austin, Angela D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2006
Last updated Oct 4th, 2019 - about 6 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 1437180072 NPPES
Virginia MEDICAID 6754406
Virginia MEDICAID 2505637

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