Provider Demographics
NPI:1558492298
Name:VARNER CLINIC
Entity Type:Organization
Organization Name:VARNER CLINIC
Other - Org Name:SCHOOL STREET OSTEOPATHIC CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:316-320-9900
Mailing Address - Street 1:700 W CENTRAL AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-2184
Mailing Address - Country:US
Mailing Address - Phone:316-320-9900
Mailing Address - Fax:316-320-7301
Practice Address - Street 1:700 W CENTRAL AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2184
Practice Address - Country:US
Practice Address - Phone:316-320-9900
Practice Address - Fax:316-320-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0517990207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS009963OtherBLUE CROSS BLUE SHIELD
KS100098490AMedicaid
KST80111Medicare UPIN
KS009963Medicare ID - Type UnspecifiedVARNER CLINIC MEDICARE