Provider Demographics
NPI:1922366251
Name:VARGASON, CAROLINE W (MD,)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:W
Last Name:VARGASON
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1603 12TH AVE RD STE E
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6100
Mailing Address - Country:US
Mailing Address - Phone:208-466-0255
Mailing Address - Fax:208-807-2331
Practice Address - Street 1:1603 12TH AVE RD STE E
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-6100
Practice Address - Country:US
Practice Address - Phone:208-466-0255
Practice Address - Fax:208-807-2331
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDM-14204207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty