Provider Demographics
NPI:1033189832
Name:JARRETT, DAVID B (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:JARRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 SEDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-1374
Mailing Address - Country:US
Mailing Address - Phone:706-338-2798
Mailing Address - Fax:706-543-8438
Practice Address - Street 1:165 SEDGEFIELD DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-1374
Practice Address - Country:US
Practice Address - Phone:706-338-2798
Practice Address - Fax:706-543-8438
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0303242084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B88074Medicare UPIN
GA26BDLKMedicare ID - Type Unspecified
GAB88074Medicare UPIN