CECIL DOUGLAS ODOM (NPI# 1093815474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093815474 |
| Entity Type | Individual |
| Full Name | CECIL DOUGLAS ODOM |
| Credential | M.D. |
| Practice Address |
1020 River Oaks Drive Ste 310 Jackson MS 39232 |
| Practice Telephone | 6019325006 |
| Practice Fax Number | 6019324548 |
| Mailing Telephone | 6019325006 |
| Mailing Fax Number | 6019324548 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
05821 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00017818 | 05 |
| Street Address |
1020 RIVER OAKS DRIVE, STE 310 |
| City | JACKSON |
| State | MS |
| Zip Code | 39232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164071775 | Leanna Nicole Howard | Social Worker | 2945 Layfair Drive, Apt. 1621, Flowood, MS 39232 | 2019-09-06 |
| 1104395565 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 4800 Lakeland Drive, Flowood, MS 39232 | 2018-11-15 |
| 1285101816 | Magnolia Anesthesia Consultants LLC | Anesthesiology | 4209 Lakeland Dr #252, Flowood, MS 39232 | 2018-11-01 |
| 1528543592 | Matthew T Armstrong | Physical Therapist | 104 Burney Drive, Flowood, MS 39232 | 2018-09-26 |
| 1790265627 | Mississippi Brain and Spine, Pllc | Non-Pharmacy Dispensing Site | 1 Layfair Drive, Ste 120, Flowood, MS 39232 | 2018-08-20 |
| 1629574918 | Billy Clifton Osbon Jr. | Pharmacist | 2506 Lakeland Drive, Suite 201, Flowood, MS 39232 | 2018-04-04 |
| 1356851752 | Oakdale Family Dentistry | Clinic/Center | 2139 Hwy 471, Flowood, MS 39232 | 2017-10-11 |
| 1992227177 | Charisma T. Cummings | Nurse Practitioner | 102 Riverview Drive, Suite A, Flowood, MS 39232 | 2017-07-10 |
| 1508398983 | Charles Pearson | Student in an Organized Health Care Education/Training Program | 764 Flowood Dr, Flowood, MS 39232 | 2017-04-03 |
| 1396288197 | Mary Claire Ponder | Nurse Practitioner | 151 E Metro Dr Ste 103, Flowood, MS 39232 | 2016-11-28 |
| Find all providers in zip 39232 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982961728 | Laura Rebecca Daily | Obstetrics & Gynecology | 501 Marshall St Ste G07, Jackson, MS 39202-1651 | 2012-04-18 |
| 1992828503 | Ann M Fenn | Obstetrics & Gynecology | 62 Redmond St, Jackson, WY 83002 | 2007-04-09 |
| 1033104070 | Molly Rheney | Obstetrics & Gynecology | 244 Coatsland Dr, Jackson, TN 38301-3948 | 2005-09-15 |
| 1912174921 | Arthur R Vendola Md PC | Obstetrics & Gynecology | 1100 E Michigan Ave, Suite 202, Jackson, MI 49201-1847 | 2008-05-09 |
| 1679742951 | Rachel F Clay | Obstetrics & Gynecology | 100 Mission Blvd, Suite 2800, Jackson, CA 95642-2536 | 2008-02-21 |
| 1114134814 | Jackson Womens Care | Obstetrics & Gynecology | 540 Jett Dr, Jackson, KY 41339-9622 | 2007-05-16 |
| 1497833446 | Joanne Ruth Kingsley | Obstetrics & Gynecology | 1931 Horton Rd, Suite 8, Jackson, MI 49203-5594 | 2006-11-01 |
| 1427136472 | Joanne Kingsley Md Pllc | Obstetrics & Gynecology | 1931 Horton Rd, Suite 8, Jackson, MI 49203-5594 | 2006-11-01 |
| 1790886133 | Beverly Ann Mcmillan | Obstetrics & Gynecology | 1020 River Oaks Dr, Suite 320, Jackson, MS 39232-9500 | 2006-09-26 |
| 1619981107 | Carl M Reddix | Obstetrics & Gynecology | 5903 Ridgewood Road, Suite 310, Reddix Medical Group, Jackson, MS 39211-3702 | 2006-07-28 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.