Doctor Name: | DR. ALAN CLIFTON ODOM |
NPI Number: | 1154390920 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 2248235 |
Business Practice Address: | 2415 Mccallie Ave Chattanooga, TN - 374043322 |
Business Phone Number: | 4236242696 |
Business Fax Number: | 4236972055 |
Mailing Address: | 2415 Mccallie Ave, CHATTANOOGA |
State: | TN |
Postal Code: | 374043322 |
Phone Number: | 4236242696 |
Fax Number: | 4236972055 |
NPI Enumeration Date: | 03/15/2006 |
NPI Last Update Date: | 11/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2248235 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |