Provider Demographics
NPI:1497765473
Name:VARNER, LAWRENCE C (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:C
Last Name:VARNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-1524
Mailing Address - Country:US
Mailing Address - Phone:434-392-6101
Mailing Address - Fax:434-392-1003
Practice Address - Street 1:400 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1524
Practice Address - Country:US
Practice Address - Phone:434-392-6101
Practice Address - Fax:434-392-1003
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005603242Medicaid
VAB07196Medicare UPIN
VA080007429Medicare ID - Type Unspecified