Provider Demographics
NPI:1073760773
Name:JARRETT, MARCO A (MD)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:A
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 1:820 N THOMPSON LN
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-4339
Mailing Address - Country:US
Mailing Address - Phone:615-494-4800
Mailing Address - Fax:615-494-4801
Practice Address - Street 1:820 N THOMPSON LN
Practice Address - Street 2:SUITE 1A
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-4339
Practice Address - Country:US
Practice Address - Phone:615-494-4800
Practice Address - Fax:615-494-4801
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45425208M00000X, 207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518931Medicaid
TNP01519685OtherRR MEDICARE
TN60483757OtherBLUE CROSS/BLUE SHIELD
TNP01519685OtherRR MEDICARE