Odom, James F

Odom, James F is an individual health care provider with primary practice located at 2041 Mesa Valley Way Suite 100, Austell GA 30106-6828. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Odom, James F can be contacted via phone (770) 944-1100.

Contact Information

Primary practice address
2041 Mesa Valley Way Suite 100 Austell GA 30106-6828
Phone: (770) 944-1100
Fax: (770) 941-7227
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005030 Georgia

Profile Details

NPI number 1790901957
LBN Legal business name Odom, James F
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 17th, 2007
Last updated May 20th, 2011 - about 14 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 1790901957 NPPES
Georgia MEDICAID 898561166G
Georgia MEDICAID 898561166H
Georgia MEDICAID 898561166F
Georgia MEDICAID 898561166I

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