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General NPI Number Information
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NPI Number | 1821160722
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Entity Type | Individual
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Provider Name | RENALDO ANDREW JARRELL MD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 2460 CURTIS ELLIS DR
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-2237
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Country | US
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Telephone | 828-456-7311
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Fax | 252-962-3320
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Provider Business Mailing Address
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Address Line | 5410 MARYLAND WAY SUITE 300
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City | BRENTWOOD
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State | TN
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Zip | 37027-5064
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Country | US
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Telephone | 615-377-5670
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Fax | 615-377-1678
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 200500953
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 200500953
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License Number State | NC
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