Provider Demographics
NPI:1073673802
Name:R.W. VARLEY, INC.
Entity Type:Organization
Organization Name:R.W. VARLEY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:VARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-222-1270
Mailing Address - Street 1:508 W CHICKASHA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-2412
Mailing Address - Country:US
Mailing Address - Phone:405-222-1270
Mailing Address - Fax:405-224-5093
Practice Address - Street 1:508 W CHICKASHA AVE
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2412
Practice Address - Country:US
Practice Address - Phone:405-222-1270
Practice Address - Fax:405-224-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK930152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100763150AMedicaid
OK100763150AMedicaid
OKOKB5162Medicare PIN
OKT40694Medicare UPIN