Provider Demographics
NPI:1326627522
Name:JARRETT, NATHAN PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:PATRICK
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 1:355 W 16TH ST STE 4300
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2394
Mailing Address - Country:US
Mailing Address - Phone:317-963-2011
Mailing Address - Fax:317-963-7533
Practice Address - Street 1:355 W 16TH ST STE 4300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2394
Practice Address - Country:US
Practice Address - Phone:317-963-2011
Practice Address - Fax:317-963-7533
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
IN11022452A390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program