JETT SURGICAL LLC NPI 1417408964

NPI Information

NPI: 1417408964
Provider Name: JETT SURGICAL LLC
Classification: Physician Assistant - 363AS0400X
Entity Type: Organization

Specialization: Surgical

Address:
915 RANDALL CT NW
MARIETTA, GA
ZIP 30064
Phone: (770) 842-1907
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JETT SURGICAL LLC is a surgical physician assistant in Marietta, GA. JETT SURGICAL LLC NPI is 1417408964. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

915 RANDALL CT NW
MARIETTA, GA
ZIP 30064-724
Phone: (770) 842-1907
Fax: (678) 214-5098

The provider's authorized official is Wendy Kae Jetton .
The authorized official title is Ceo and has the following contact phone number (770) 842-1907.

The enumeration date for this NPI number is 10/19/2016 and was last updated on 12/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	1256	GEORGIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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