Provider Demographics
NPI:1336323740
Name:GARRETT, JEFFREY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:PAUL
Last Name:GARRETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:503 BOWMAN GRAY DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7286
Mailing Address - Country:US
Mailing Address - Phone:252-816-4001
Mailing Address - Fax:252-816-4009
Practice Address - Street 1:503 BOWMAN GRAY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7286
Practice Address - Country:US
Practice Address - Phone:252-816-4001
Practice Address - Fax:252-816-4009
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250061207X00000X
FLME108881207X00000X
GA067569207X00000X
NC132072207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I017019Medicare PIN
GA003126113AMedicaid
GA003126113BMedicaid