Provider Demographics
NPI:1487622452
Name:TARLETON, JACK (PHD)
Entity type:Individual
Prefix:DR
First Name:JACK
Middle Name:
Last Name:TARLETON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 ARCO RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1921
Mailing Address - Country:US
Mailing Address - Phone:828-298-5270
Mailing Address - Fax:
Practice Address - Street 1:267 MCDOWELL ST
Practice Address - Street 2:FULLERTON GENETICS LABORATORY
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2606
Practice Address - Country:US
Practice Address - Phone:828-213-1015
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics