Provider Demographics
NPI:1821210428
Name:DR ROBERTO A VARGAS INC
Entity Type:Organization
Organization Name:DR ROBERTO A VARGAS INC
Other - Org Name:DR. ROBERTO ANIBAL VARGAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:ANIBAL
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-575-1300
Mailing Address - Street 1:1375 PEACHTREE ST NE
Mailing Address - Street 2:SUITE A9
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3173
Mailing Address - Country:US
Mailing Address - Phone:404-575-1300
Mailing Address - Fax:404-575-1301
Practice Address - Street 1:1375 PEACHTREE ST
Practice Address - Street 2:SUITE A9
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3117
Practice Address - Country:US
Practice Address - Phone:404-575-1300
Practice Address - Fax:404-575-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1760534887OtherINDIVIDUAL NPI#