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NPI Code Detail

MEDICARE: CARMINE V ODDIS M.D.

MEDICARE: CARMINE V ODDIS M.D.
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
12085N0904XNuclear Radiology Physician51072GA
2207RC0000XCardiovascular Disease Physician51072GA
3207RC0001XClinical Cardiac Electrophysiology Physician51072GA

General Provider Information

NPI Number : 1659315737
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMINE V ODDIS M.D.
Provider Business Mailing Address
First Line : 1062 FORSYTH ST STE 1B
Second Line :
City : MACON
State : GA
Zip : 31201-8638
Country : US
Telephone Number : 478-741-1208
Fax Number : 478-741-1557
Provider Business Practice Location Address
First Line : 1062 FORSYTH ST STE 1B
Second Line :
City : MACON
State : GA
Zip : 31201-8638
Country : US
Telephone Number : 478-741-1208
Fax Number : 478-741-1557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 05/19/2026

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