| Mrs Carla Odom, | |
|
963 Taylor Rd, Kokomo, MS 39643-4967 | |
| (601) 303-0050 | |
| Not Available |
| Full Name | Mrs Carla Odom |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 963 Taylor Rd, Kokomo, Mississippi |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043827900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 904705 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke Home Health Services | Mccomb, MS | Home health agency |
| Forrest General Home Care | Hattiesburg, MS | Home health agency |
| Walthall County General Hospital Cah | Tylertown, MS | Hospital |
| Southwest Ms Regional Medical Center | Mccomb, MS | Hospital |
| Marion General Hospital | Columbia, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Blackwells Family Medicine Llc | 0749616381 | 4 |
| Entity Name | Blackwells Family Medicine Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366003436 PECOS PAC ID: 0749616381 Enrollment ID: O20200130001390 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Carla Odom, 107 Ball Ave, Tylertown, MS 39667-2101 Ph: (601) 377-1975 | Mrs Carla Odom, 963 Taylor Rd, Kokomo, MS 39643-4967 Ph: (601) 303-0050 |
Mrs. Kimberly Cathleen Martin, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 607 Old Highway 24 W, Kokomo, MS 39643 Phone: 601-674-0508 | |
Timothy Paul Martin, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 607 Old Highway 24 W, Kokomo, MS 39643 Phone: 985-202-8812 |