Mary Odofin MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

31854 Issued in AL

Legal business name

MARY ODOFIN MD PC

Practice address

250 Chateau Dr SW
Suite 220
Huntsville, AL 35801-6436

Phone

(256) 881-1989

Fax

(256) 319-1368

NPI assigned

Aug 15, 2012

Last updated

Aug 20, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barbara McAnally

Title

Business Manager

Phone

(256) 881-1835

Specialties & licenses 1

Addresses

Other names 1

• Olaoluwa Odofin MD Other name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olaoluwa Mary Odofin, M.D

  • Internal Medicine Physician
  • Huntsville, AL
  • NPI 1134491830
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1710235262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHATEAU DR SW",
            "address_2": "SUITE 220",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016436",
            "telephone_number": "256-881-1989",
            "fax_number": "256-319-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHATEAU DR SW",
            "address_2": "SUITE 220",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016436",
            "telephone_number": "256-881-1989",
            "fax_number": "256-319-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ODOFIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "MCANALLY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "256-881-1835"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "31854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olaoluwa Odofin MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David Joseph Martinez, MD
• Emily Martinez
• Alexandra Martinsen
• Baylee Martz, CRNP
• Hannah Caroline Martz
• Mary Schappell, LLC
• Lionel Anthony Marzette, M.D.
• Lynda Jean Masco, CRNP
• Abbey Smith Mask, CRNP
• Alexis Tanishia Mason, MD

• Internal Medicine Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Internal Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.