IndividualActive
John Odom, MD
NPI 1215953732 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Eden Prairie, MN
Provider details
- NPI number
- 1215953732
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 44235 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Phone: (952) 224-1919
Fax: (612) 999-1943
Approximate (ZIP-level) locationGet directions
Mailing address
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Registry dates
- Enumerated
- 2006-07-15
- Last updated
- 2026-04-29
- Certified
- 2026-04-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.