WATER VALLEY RURAL HEALTH PAUL ODOM MD (NPI# 1912070277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912070277 |
Entity Type | Organization |
Organization Name | WATER VALLEY RURAL HEALTH PAUL ODOM MD |
Practice Address |
645 South Main Street Water Valley MS 38965 |
Mailing Address |
Po Box 725 645 S Main Street Water Valley MS 38965 |
Practice Telephone | 6624731311 |
Practice Fax Number | 6624732489 |
Mailing Telephone | 6624731311 |
Mailing Fax Number | 6624732489 |
Enumeration Date | 2006-11-16 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MR. PAUL LEROY ODOM (OWNER) |
Authorized Official Telephone | 6624731311 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 09013597 | 05 | |
MEDICARE RIVERBEND | 253848 | 01 |
Street Address |
645 SOUTH MAIN STREET |
City | WATER VALLEY |
State | MS |
Zip Code | 38965 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356402002 | Yalobusha General Hospital | Clinic/Center | 645 South Main Street, Water Valley, MS 38965 | 2006-12-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083087985 | Family Health Care Clinic, Inc. | Clinic/Center | 102 Blackmur Dr, Water Valley, MS 38965 | 2015-11-02 |
1770713893 | Ben F Toole | Counselor | 1285 County Road 151, Water Valley, MS 38965 | 2009-07-23 |
1053451880 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | 630 South Main St, Water Valley, MS 38965 | 2007-02-08 |
1003977281 | Barney Lee Pullen Jr. | Dentist | 117 Wood St, Water Valley, MS 38965 | 2006-12-12 |
1255414173 | Family Practice Clinic of Water Valley | Family Medicine | 606 So Main St, Water Valley, MS 38965 | 2006-10-23 |
1073609467 | Paul Leroy Odom | Family Medicine | 604 South Main Street, Water Valley, MS 38965 | 2006-10-05 |
1730129164 | Quality Medical Service, Inc | Durable Medical Equipment & Medical Supplies | Quality Medical Services, Inc, 48 S Main Street, Water Valley, MS 38965 | 2006-06-07 |
1124687207 | Dontavious Toles | Physical Therapy Assistant | 50 Main St, Water Valley, MS 38965 | 2019-06-11 |
1669826111 | Antoinette Taylor | Family Medicine | 604 S Main St, Water Valley, MS 38965 | 2016-04-21 |
1659607232 | Cinnamon Caryl Foster | Nurse Practitioner | 712 S Main St, Water Valley, MS 38965 | 2009-11-02 |
Find all providers in zip 38965 |
Taxonomy Code | 261QR1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rural Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356402002 | Yalobusha General Hospital | Clinic/Center | 645 South Main Street, Water Valley, MS 38965 | 2006-12-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730786120 | Ochsner Medical Center - Hancock, LLC | Clinic/Center | 2274 Highway 43 S Ste 200, Picayune, MS 39466-8141 | 2020-10-08 |
1306460282 | Covington County Hospital | Clinic/Center | 105 Eaton St, Taylorsville, MS 39168-5614 | 2020-06-05 |
1871117747 | Covington County Hospital | Clinic/Center | 1039 Highway 42 Ste C, Sumrall, MS 39482-4478 | 2020-06-05 |
1194365338 | Bounds Family Medical | Clinic/Center | 870 Main St Ste A, Fayette, MS 39069-5695 | 2020-01-15 |
1720649577 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 19 Third St, Belmont, MS 38827 | 2019-06-24 |
1255999611 | Boa Vida Hospital of Aberdeen, Ms LLC | Clinic/Center | 400 3rd Ave 32 West, New Houlka, MS 38850 | 2019-05-31 |
1598238545 | South Sunflower County Hospital | Clinic/Center | 1001 West Delta, Moorhead, MS 38761 | 2019-01-02 |
1790272185 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 670 Ms-178, Suite 5, Sherman, MS 38869 | 2018-04-20 |
1124515515 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 2200 5th St N, Columbus, MS 39705-2212 | 2018-04-20 |
1205323698 | Boa Vida Hospital of Aberdeen, Ms, LLC | Clinic/Center | 815 2nd Ave N, Columbus, MS 39701-4703 | 2018-04-20 |
Find all providers with the same taxonomy |
City | WATER VALLEY |
Zip Code | 38965 |
Please comment or provide details below to improve the information on WATER VALLEY RURAL HEALTH PAUL ODOM MD.
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.