Carol M Odegaard, M.D.
Family Medicine in Jackson, GA. Individual provider (NPI-1).
NPI number1700876554
StatusActive
Last updated in NPPESMay 7, 2019
Details
- NPI
- 1700876554
- Entity type
- Individual (NPI-1)
- Name
- Carol M Odegaard
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 24, 2005
- Last updated
- May 7, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 40495 | GA | Yes |
Practice location
261 Brookwood AveJackson, GA 30233-1460
Phone 678-752-0555 · Fax 678-752-0556
Mailing address
261 Brookwood AveJackson, GA 30233-1460
Phone 678-752-0555 · Fax 678-752-0556
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