Individual
SHANT HAGOP GARABEDIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
367 HOSPITAL BLVD, JACKSON, TN 38305-2080
(731) 661-2095
Mailing address
118 BARRETT PL, JACKSON, TN 38305-1918
(731) 695-8215
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1274
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3830111
—
TN
05
—
3830112
—
TN
01
—
4105328
BCBS
—
01
—
P00268882
RR MEDICARE
—
Enumeration date
07/04/2006
Last updated
02/09/2010
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