Provider Demographics
NPI:1275039166
Name:GARRETT, JOHN JR (PHD, MSN, MPH,NRAEMT)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:GARRETT
Suffix:JR
Gender:M
Credentials:PHD, MSN, MPH,NRAEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 PEACHTREE RD NW # 915-9165
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2918
Mailing Address - Country:US
Mailing Address - Phone:404-666-6641
Mailing Address - Fax:
Practice Address - Street 1:501 E BROADWAY STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1797
Practice Address - Country:US
Practice Address - Phone:404-666-6641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-01
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX753196146N00000X
KY1120796146L00000X, 207PE0004X
FL560197146N00000X
IL041394425163WI0600X, 163WI0600X
GAA033394146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services