Provider Demographics
NPI:1568482099
Name:GARRINGER, JODON (MD)
Entity type:Individual
Prefix:
First Name:JODON
Middle Name:
Last Name:GARRINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 ATHENS ST
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643-1854
Mailing Address - Country:US
Mailing Address - Phone:706-376-3957
Mailing Address - Fax:706-376-3158
Practice Address - Street 1:229 ATHENS ST
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643-1854
Practice Address - Country:US
Practice Address - Phone:706-376-3957
Practice Address - Fax:706-376-1356
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000897707AMedicaid
GACB5824OtherRAILROAD MEDICARE
GAG71276Medicare UPIN
GA000897707AMedicaid