Individual
JUSTIN D GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
550 UNIVERSITY BLVD # UH0481, INDIANAPOLIS, IN 46202-5149
(317) 274-0275
(317) 274-0256
Mailing address
550 UNIVERSITY BLVD # UH0481, INDIANAPOLIS, IN 46202-5149
(317) 274-0275
(317) 274-0256
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000017A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001258478
ANTHEM PTAN
IN
Enumeration date
08/21/2017
Last updated
12/03/2024
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