Provider Demographics
NPI:1154438091
Name:HUGH M. DEJARNETTE JR.
Entity type:Organization
Organization Name:HUGH M. DEJARNETTE JR.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEJARNETTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:770-979-9331
Mailing Address - Street 1:1550 JANMAR RD # B
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5600
Mailing Address - Country:US
Mailing Address - Phone:770-979-9331
Mailing Address - Fax:770-979-8827
Practice Address - Street 1:1550 JANMAR RD # B
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5600
Practice Address - Country:US
Practice Address - Phone:770-979-9331
Practice Address - Fax:770-979-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty