Healthcare Provider Details

I. General information

NPI: 1275858193
Provider Name (Legal Business Name): THOMAS WILLIAM ODEN III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2010
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 PINEHURST DR
NEW ORLEANS LA
70131-3355
US

IV. Provider business mailing address

14 PINEHURST DR
NEW ORLEANS LA
70131-3355
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-4272
  • Fax:
Mailing address:
  • Phone: 404-202-4151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number82769
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD.206037
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA137703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: