Healthcare Provider Details

I. General information

NPI: 1356344105
Provider Name (Legal Business Name): SAMUEL DAVID JARRETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 02/08/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 VICTORIA RD
ASHEVILLE NC
28801-4811
US

IV. Provider business mailing address

111 VICTORIA RD
ASHEVILLE NC
28801-4811
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-7331
  • Fax: 828-250-9208
Mailing address:
  • Phone: 828-252-7331
  • Fax: 828-250-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number200201370
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: