1013208370 NPI number — CHRIS A. VARVA, DPM, PLLC

Table of content: (NPI 1013208370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013208370 NPI number — CHRIS A. VARVA, DPM, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHRIS A. VARVA, DPM, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FOOT SPECIALIST
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013208370
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1001 S LAKE CV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OXFORD
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38655-9211
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-832-3338
Provider Business Mailing Address Fax Number:
888-371-8341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2168 S LAMAR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OXFORD
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38655-5224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-832-3338
Provider Business Practice Location Address Fax Number:
888-371-8341
Provider Enumeration Date:
04/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
VARVA
Authorized Official First Name:
CHRIS
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PODIATRIST/ OWNER
Authorized Official Telephone Number:
662-832-3338

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 302G484759 . This is a "MEDICARE PTAN" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".




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