Provider Demographics
NPI:1447392816
Name:JARRETT SURGERY LLC
Entity Type:Organization
Organization Name:JARRETT SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:P
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-281-2905
Mailing Address - Street 1:39 W KAMEHAMEHA AVE
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2263
Mailing Address - Country:US
Mailing Address - Phone:808-281-2905
Mailing Address - Fax:
Practice Address - Street 1:39 W KAMEHAMEHA AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2263
Practice Address - Country:US
Practice Address - Phone:808-281-2905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI13087174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty