Provider Demographics
NPI:1497806111
Name:VARGO, STEPHEN THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS
Last Name:VARGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6020 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118
Mailing Address - Country:US
Mailing Address - Phone:702-737-5021
Mailing Address - Fax:702-733-1689
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:550
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-648-9400
Practice Address - Fax:702-636-0249
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI39827208600000X
NV13258208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery