Provider Demographics
NPI:1326385089
Name:JARRETT, CHRISTOPHER ALAN
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:ALAN
Last Name:JARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4895 WINTERVIEW LN
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1991
Mailing Address - Country:US
Mailing Address - Phone:770-577-1201
Mailing Address - Fax:
Practice Address - Street 1:4300 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-4200
Practice Address - Country:US
Practice Address - Phone:770-577-5139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018360183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist