Provider Demographics
NPI:1407928377
Name:VARNER, KEVIN SCOTT (SFIDC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:SCOTT
Last Name:VARNER
Suffix:
Gender:M
Credentials:SFIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS JOHN S. MCCAIN DDG-56
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96672
Mailing Address - Country:US
Mailing Address - Phone:314-241-9966
Mailing Address - Fax:
Practice Address - Street 1:USS JOHN S. MCCAIN DDG-56
Practice Address - Street 2:
Practice Address - City:FPO AP
Practice Address - State:CA
Practice Address - Zip Code:96672-1274
Practice Address - Country:US
Practice Address - Phone:314-241-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman