Basic Information
| Provider Information | |||||||||
| NPI: | 1053421552 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALLENDER | ||||||||
| FirstName: | ODETTE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1290 | ||||||||
| Address2: | |||||||||
| City: | FOREST | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245511290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4343855600 | ||||||||
| FaxNumber: | 4344557172 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 MEMORIAL DR STE A | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 245411680 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4347993232 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 01/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 0101043505 | VA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.