Provider Demographics
NPI:1902829526
Name:VARGO, RONALD GEORGE (DO)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:GEORGE
Last Name:VARGO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 W COSHOCTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-9581
Mailing Address - Country:US
Mailing Address - Phone:740-212-1212
Mailing Address - Fax:740-212-1212
Practice Address - Street 1:738 W COSHOCTON ST STE A
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43031-9581
Practice Address - Country:US
Practice Address - Phone:740-212-1212
Practice Address - Fax:740-212-1213
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-003688V207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0607909Medicaid
OHVA0573151Medicare ID - Type Unspecified
OH0607909Medicaid