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General NPI Number Information
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NPI Number | 1427588698
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Entity Type | Individual
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Provider Name | JAMIE L ODDEN
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Gender | Female
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 4411 THE 25 WAY NE STE 325
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5853
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Country | US
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Telephone | 505-823-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 THE 25 WAY NE STE 325
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5853
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Country | US
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Telephone | 505-823-4411
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD2023-1007
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 63914
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | MD2023-1007
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License Number State | NM
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