Provider Demographics
NPI:1003025347
Name:VARNADO, ANJANETTE L (MD)
Entity Type:Individual
Prefix:
First Name:ANJANETTE
Middle Name:L
Last Name:VARNADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6214 HIGHWAY 10
Mailing Address - Street 2:PO BOX 1178
Mailing Address - City:GREENSBURG
Mailing Address - State:LA
Mailing Address - Zip Code:70441
Mailing Address - Country:US
Mailing Address - Phone:225-222-3206
Mailing Address - Fax:225-222-3190
Practice Address - Street 1:6214 HIGHWAY 10
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:LA
Practice Address - Zip Code:70441
Practice Address - Country:US
Practice Address - Phone:225-222-3206
Practice Address - Fax:225-222-3190
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1239321Medicaid
LA4N119CB65Medicare PIN