Provider Demographics
NPI:1699431619
Name:ODELL, KARL A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:A
Last Name:ODELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7265 SEASHELL LN SW UNIT 301
Mailing Address - Street 2:
Mailing Address - City:OCEAN ISLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28469-4204
Mailing Address - Country:US
Mailing Address - Phone:606-831-7012
Mailing Address - Fax:
Practice Address - Street 1:7265 SEASHELL LN SW UNIT 301
Practice Address - Street 2:
Practice Address - City:OCEAN ISLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28469-4204
Practice Address - Country:US
Practice Address - Phone:606-831-7012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-14
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist