MEDICARE: DR. ROBERT H. ODELL JR. M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	5774	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013957026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT H. ODELL JR. M.D., PH.D.

Provider Business Mailing Address
First Line	:	8635 W SAHARA
Second Line	:	660
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5816
Country	:	US
Telephone Number	:	702-257-7246
Fax Number	:	702-586-2071

Provider Business Practice Location Address
First Line	:	8084 W SAHARA AVE
Second Line	:	SUITE E
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1977
Country	:	US
Telephone Number	:	702-247-7246
Fax Number	:	702-586-2071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	10/27/2023

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Directions to “ DR. ROBERT H. ODELL JR. M.D., PH.D.” Practice Location

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