MEDICARE: DR. NATHANIEL MONNET ODOR MD

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	207X00000X	Orthopaedic Surgery Physician	DR.0066085	CO
2	207X00000X	Orthopaedic Surgery Physician	32402	OK
3	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	DR.0066085	CO

General Provider Information

NPI Number	:	1588010656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHANIEL MONNET ODOR MD

Provider Business Mailing Address
First Line	:	9800 BROADWAY EXT STE 201
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-6304
Country	:	US
Telephone Number	:	405-906-4059
Fax Number	:	405-920-6377

Provider Business Practice Location Address
First Line	:	9800 BROADWAY EXT STE 201
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-6304
Country	:	US
Telephone Number	:	405-906-4059
Fax Number	:	405-920-6377

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

Provider Enumeration Date	:	05/09/2016
Last Update Date	:	03/18/2026

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