Provider Demographics
NPI:1619349628
Name:VARNER, WILBUR SR
Entity Type:Individual
Prefix:MR
First Name:WILBUR
Middle Name:
Last Name:VARNER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BRES AVE STE G
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5869
Mailing Address - Country:US
Mailing Address - Phone:318-509-8073
Mailing Address - Fax:318-703-5765
Practice Address - Street 1:215 BRES AVE STE G
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5869
Practice Address - Country:US
Practice Address - Phone:318-509-8073
Practice Address - Fax:318-703-5765
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health