Provider Demographics
NPI:1588010656
Name:ODOR, NATHANIEL MONNET (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:MONNET
Last Name:ODOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3110 SW 89TH ST STE 200D
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7919
Mailing Address - Country:US
Mailing Address - Phone:405-906-4059
Mailing Address - Fax:405-920-6377
Practice Address - Street 1:3110 SW 89TH ST STE 200D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7919
Practice Address - Country:US
Practice Address - Phone:405-906-4059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32402207X00000X
CODR.0066085207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery