Individual
CHARLES PHILLIP DE JARNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
303 PARKWAY DR NE, ATLANTA, GA 30312-1212
(404) 265-4000
Mailing address
PO BOX 932925, ATLANTA, GA 31193-2925
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
024925
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142005
BCBSGA (NSC)
GA
01
—
714223
BCBSGA (AMC)
GA
01
—
P00184620
RAILROAD MEDICARE
GA
Enumeration date
05/31/2006
Last updated
02/19/2008
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