Individual
JASON ADAM MYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2863 HIGHWAY 45 BYP, JACKSON, TN 38305-3618
(731) 664-1375
(731) 664-1378
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 423-8697
(731) 422-5743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45613
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518514
—
TN
Enumeration date
04/10/2008
Last updated
11/29/2012
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