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General NPI Number Information
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NPI Number | 1972965689
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Entity Type | Individual
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Provider Name | BRITTANY KALISSE ODOM M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 63 MEDICAL CENTER DR
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City | WEST POINT
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State | MS
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Zip | 39773-0430
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Country | US
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Telephone | 662-494-1620
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Fax | 662-494-0375
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Provider Business Mailing Address
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Address Line | 63 MEDICAL CENTER DR
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City | WEST POINT
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State | MS
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Zip | 39773-0430
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Country | US
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Telephone | 662-494-1620
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Fax | 662-494-0375
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036-152382
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD2022-0892
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 33590
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License Number State | MS
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