Provider Demographics
NPI:1841291671
Name:MONETTE, JEAN GERARD (MD)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:GERARD
Last Name:MONETTE
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 1:235 COUNTRY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-6943
Mailing Address - Country:US
Mailing Address - Phone:731-644-3633
Mailing Address - Fax:
Practice Address - Street 1:235 COUNTRY WOOD DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-6943
Practice Address - Country:US
Practice Address - Phone:731-644-3633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000238762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3071146Medicaid
TN3071146Medicaid