Provider Demographics
NPI:1700919503
Name:JARRETT FERTILITY GROUP
Entity Type:Organization
Organization Name:JARRETT FERTILITY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:317-814-4110
Mailing Address - Street 1:11725 N ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3008
Mailing Address - Country:US
Mailing Address - Phone:317-814-4110
Mailing Address - Fax:317-814-4114
Practice Address - Street 1:11725 N ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3008
Practice Address - Country:US
Practice Address - Phone:317-814-4110
Practice Address - Fax:317-814-4114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B76703Medicare UPIN