Healthcare Provider Details

I. General information

NPI: 1801075734
Provider Name (Legal Business Name): O2 DIAGNOSTICS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2007
Last Update Date: 10/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 POPLAR SPRINGS RD
HUNTINGDON TN
38344-8867
US

IV. Provider business mailing address

915 POPLAR SPRINGS RD
HUNTINGDON TN
38344-8867
US

V. Phone/Fax

Practice location:
  • Phone: 731-986-0121
  • Fax: 731-986-0094
Mailing address:
  • Phone: 731-986-0121
  • Fax: 731-986-0094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL S JARRETT
Title or Position: PRESIDENT / OWNER
Credential: CRT/ LPM
Phone: 731-986-0121