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Physician Compare National (NPI:1639118953)

HEALTHCARE PROVIDER: FRANK ALPHONSO ODLUM M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1639118953
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2769572593
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20071218000078
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name ODLUM
Individual professional last name
Provider First Name FRANK
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Individual professional's medical school
Graduation Year 1990
Individual professional's medical school graduation year
Primary Specialty GENERAL SURGERY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 9149 ESTATE THOMAS
Group Practice or individual's line 1 address
Line 2 Street Address PARAGON MED BLDG 302
Group Practice or individual's line 2 address
City ST THOMAS
Group Practice or individual's city
State VI
Group Practice or individual's state
Zip Code 008022615
Group Practice or individual's zip code (9 digits when available)
Phone Number 3407778599
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 480001
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 ROY LESTER SCHNEIDER HOSPITAL,THE
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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