Provider Demographics
NPI:1700863867
Name:VARLEY, JOSEPH DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAVID
Last Name:VARLEY
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 1:444 N MAIN ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44310-3110
Mailing Address - Country:US
Mailing Address - Phone:330-379-9548
Mailing Address - Fax:330-379-5124
Practice Address - Street 1:444 N MAIN ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-3110
Practice Address - Country:US
Practice Address - Phone:330-379-9548
Practice Address - Fax:330-379-5124
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0578132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0822426Medicaid
OH0822426Medicaid
VA 0652986Medicare ID - Type Unspecified