Individual
JAY ROBERT JETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25807 NW 122ND AVE, HIGH SPRINGS, FL 32643-5025
(352) 316-5492
Mailing address
1600 SW ARCHER RD, BOX 100286, GAINESVILLE, FL 32610-0286
(352) 265-0761
(352) 265-1060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9113440
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/10/2020
Last updated
10/29/2020
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