Provider Demographics
NPI:1033256649
Name:VARNER, JEFFREY L (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:VARNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2833
Mailing Address - Country:US
Mailing Address - Phone:215-699-2020
Mailing Address - Fax:215-699-2020
Practice Address - Street 1:116 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2833
Practice Address - Country:US
Practice Address - Phone:215-699-2020
Practice Address - Fax:215-699-2020
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA-6648-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA019781Medicare ID - Type Unspecified
PAT27077Medicare UPIN