MEDICARE: DR. LAUREN VICTORIA ODOM MD, MPH

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437832102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREN VICTORIA ODOM MD, MPH

Provider Business Mailing Address
First Line	:	3319 CLIFF RD S APT A
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2055 E SOUTH BLVD STE 200
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2002
Country	:	US
Telephone Number	:	334-747-7597
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2023
Last Update Date	:	04/06/2026

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