JETT SURGICAL LLC NPI 1417408964

NPI Information

  • NPI: 1417408964
  • Provider Name: JETT SURGICAL LLC
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Organization
  • Address: 915 RANDALL CT NW
    MARIETTA, GA
    ZIP 30064
  • Phone: (770) 842-1907

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NPI Details

JETT SURGICAL LLC is a surgical physician assistant in Marietta, GA. JETT SURGICAL LLC NPI is 1417408964. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

915 RANDALL CT NW
MARIETTA, GA
ZIP 30064-724
Phone: (770) 842-1907
Fax: (678) 214-5098

The provider's authorized official is Wendy Kae Jetton .
The authorized official title is Ceo and has the following contact phone number (770) 842-1907.

The enumeration date for this NPI number is 10/19/2016 and was last updated on 12/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AS0400XPhysician AssistantSurgical1256GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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