Basic Information
| Provider Information | |||||||||
| NPI: | 1073760773 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JARRETT | ||||||||
| FirstName: | MARCO | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 820 N THOMPSON LN | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371294339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154944800 | ||||||||
| FaxNumber: | 6154944801 | ||||||||
| Practice Location | |||||||||
| Address1: | 820 N THOMPSON LN | ||||||||
| Address2: | SUITE 1A | ||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371294339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154944800 | ||||||||
| FaxNumber: | 6154944801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2008 | ||||||||
| LastUpdateDate: | 12/17/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 45425 | TN | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | 45425 | TN | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1518931 | 05 | TN | MEDICAID | P01519685 | 01 | TN | RR MEDICARE | OTHER | 60483757 | 01 | TN | BLUE CROSS/BLUE SHIELD | OTHER |