Provider Demographics
NPI:1477050573
Name:ODOM, TRAVIS LEE (MD)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:LEE
Last Name:ODOM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2100 STANTONSBURG RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2818
Mailing Address - Country:US
Mailing Address - Phone:252-744-2335
Mailing Address - Fax:252-744-3811
Practice Address - Street 1:PO BOX 11049
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23517-0049
Practice Address - Country:US
Practice Address - Phone:757-668-7871
Practice Address - Fax:757-668-8658
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2024-09-24
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Provider Licenses
StateLicense IDTaxonomies
VA01012819712080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine