MEDICARE: ODYSSEY HEALTHCARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	1795	OK

General Provider Information

NPI Number	:	1003982984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ODYSSEY HEALTHCARE

Provider Business Mailing Address
First Line	:	2233 NW 57TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7303
Country	:	US
Telephone Number	:	405-615-9111
Fax Number	:

Provider Business Practice Location Address
First Line	:	2212 NW 50TH ST
Second Line	:	SUITE 246
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-8086
Country	:	US
Telephone Number	:	405-879-3400
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	TIMOTHY SILER
Credential	:	MD
Telephone Number	:	405-879-3400

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	08/22/2020

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Directions to “ODYSSEY HEALTHCARE ” Practice Location

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