Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOHN ODOM, MD
ActiveJOHN ODOM, MD is a Sports Medicine (PM&R) healthcare provider located in EDEN PRAIRIE, Minnesota. NPI 1215953732 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · EDEN PRAIRIE, MN
Registration Details
- NPI Number
- 1215953732
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 15, 2006 (20.122760983976 yrs)
- Last Updated
- Jun 25, 2024
- Licenses
-
44235 (MN)44235 (MN)
Practice Information
- Address
-
6545 FLYING CLOUD DR STE 201EDEN PRAIRIE, MN, 553443356Browse MN providers · Browse ZIP 55344
- Phone
- 9522241919
- Fax
- 7637108154
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
- Additional Specialty
- Sports Medicine (PM&R)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.