Provider Demographics
NPI:1477521987
Name:VARVA, CHRIS A (DPM)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:A
Last Name:VARVA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S LAKE CV
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-9211
Mailing Address - Country:US
Mailing Address - Phone:662-832-3338
Mailing Address - Fax:888-371-8341
Practice Address - Street 1:2168 S LAMAR BLVD
Practice Address - Street 2:PRACTICE LOCATION-NOT MAILING ADDRESS
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5224
Practice Address - Country:US
Practice Address - Phone:662-832-3338
Practice Address - Fax:888-371-8341
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1309213E00000X
MS80190213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS302I484759OtherMEDICARE PTAN
MS302I484759Medicare PIN