Provider Demographics
NPI:1174917470
Name:JARRETT, THOMAS MERRYFIELD (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MERRYFIELD
Last Name:JARRETT
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 PEACHTREE RD NW
Mailing Address - Street 2:STE 915-3296
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2918
Mailing Address - Country:US
Mailing Address - Phone:919-926-8331
Mailing Address - Fax:
Practice Address - Street 1:2870 PEACHTREE RD NW STE 915-3296
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2918
Practice Address - Country:US
Practice Address - Phone:919-926-8331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-24
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA81985208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program