MEDICARE: DR. HELEN M ODONNELL MD

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	208100000X	Physical Medicine & Rehabilitation Physician	31061	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000306733	OTHER	KY	ANTHEM

General Provider Information

NPI Number	:	1487636007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HELEN M ODONNELL MD

Provider Business Mailing Address
First Line	:	411 BAYSHORE DR
Second Line	:	UNIT G
City	:	PENSACOLA
State	:	FL
Zip	:	32507-3574
Country	:	US
Telephone Number	:	859-749-6638
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 BAYSHORE DR
Second Line	:	UNIT G
City	:	PENSACOLA
State	:	FL
Zip	:	32507-3574
Country	:	US
Telephone Number	:	859-749-6638
Fax Number	:

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

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	01/15/2016

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