National Provider Identifier Database

THOMAS G ODANIEL JR, MD – NPI #1871585018
Plastic and Reconstructive Surgery

Contact Information

THOMAS G ODANIEL JR, MD
222 S 1ST ST
SUITE 100
LOUISVILLE, KY  40202-1350
Phone: 502-584-1109
Fax: 502-589-6882
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X

* Indicates primary specialty

NPI Profile & details for THOMAS G ODANIEL JR

NPI Number 1871585018
Credentials MD
Entity Individual
Enumeration date 08/15/2005
Last updated 04/04/2016 - About 10 years ago
Sole proprietor1 Yes
Identifiers
  • KY License #: 24070
  • IN Medicaid: 100033340A
  • KY Medicaid: 64240708
  • KY Other: 000000219660 ANTHEM PIN
  • KY Other: 002 CIGNA
  • KY Other: 667357 HEALTHLINK
  • KY Other: KY1118 HEALTHNET PIN
  • KY Other: 1058697 PASSPORT PIN
  • KY Other: KY0057799 TRICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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