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General NPI Number Information
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NPI Number | 1083091110
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Entity Type | Individual
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Provider Name | FLORENE DIXON ODULANA M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 08/12/2019
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Provider Practice Location Address
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Address Line | UNIVERSITY OF TENNESSEE 910 MADISON AVE SUITE 1031
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City | MEMPHIS
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State | TN
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Zip | 38163-0001
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Country | US
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Telephone | 901-448-4795
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Fax |
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Provider Business Mailing Address
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Address Line | 853 JEFFERSON AVE RM E102
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City | MEMPHIS
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State | TN
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Zip | 38103-2807
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Country | US
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Telephone | 901-448-4795
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 59691
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License Number State | TN
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