Provider Demographics
NPI:1568896470
Name:JARRETT, WILLIAM PRESCOTT (PA-C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PRESCOTT
Last Name:JARRETT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ELDON PARKS DR STE B
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2459
Mailing Address - Country:US
Mailing Address - Phone:336-526-0188
Mailing Address - Fax:
Practice Address - Street 1:101 ELDON PARKS DR STE B
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2459
Practice Address - Country:US
Practice Address - Phone:336-526-0188
Practice Address - Fax:336-526-4369
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5492363AM0700X
NC0010-05114363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical