Provider Demographics
NPI:1659318723
Name:JARRETT, ROBERT AUGUSTUS (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:AUGUSTUS
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 1:789 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-609-6819
Mailing Address - Fax:
Practice Address - Street 1:789 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2526
Practice Address - Country:US
Practice Address - Phone:603-609-6819
Practice Address - Fax:603-609-6821
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038260207L00000X
NH11195207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008160Medicaid
NH3097836Medicaid
GA000608517KMedicaid
GA000608517JMedicaid
F82903Medicare UPIN
GA93BFBFLMedicare ID - Type UnspecifiedMEDICARE
NH30201697Medicaid
VT1008160Medicaid