Provider Demographics
NPI:1407145089
Name:JEFFREY L. VARNER
Entity Type:Organization
Organization Name:JEFFREY L. VARNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-699-2020
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA-06648-T332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT27077Medicare UPIN
PA019781Medicare PIN