IndividualActive
Carl Odom, MD
NPI 1740523513 · Diagnostic Radiology Physician · Boise, ID
Provider details
- NPI number
- 1740523513
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- T0301 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
620 W Hays St
Boise, ID 83702-5511
Phone: (208) 381-2094
Fax: (208) 381-1791
Approximate (ZIP-level) locationGet directions
Mailing address
12554 Riata Vista Cir
Austin, TX 78727-6431
Registry dates
- Enumerated
- 2013-03-31
- Last updated
- 2023-09-12
- Certified
- 2023-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.