MEDICARE: ODYSSEY HEALTHCARE INC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1265515712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ODYSSEY HEALTHCARE INC

Provider Business Mailing Address
First Line	:	2 W MAIN ST STE 200
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73401-6503
Country	:	US
Telephone Number	:	580-223-3383
Fax Number	:	580-223-6696

Provider Business Practice Location Address
First Line	:	2 W MAIN ST
Second Line	:	SUITE 200
City	:	ARDMORE
State	:	OK
Zip	:	73401-6505
Country	:	US
Telephone Number	:	580-223-3383
Fax Number	:	580-223-6696

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ROBERT BLACKWELL
Credential	:
Telephone Number	:	580-223-3383

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	03/02/2026

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Directions to “ODYSSEY HEALTHCARE INC ” Practice Location

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