Provider Demographics
NPI:1245210657
Name:VARNAU, JUDITH A (DO)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:VARNAU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7661 WHITE SWAN ROAD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-9518
Mailing Address - Country:US
Mailing Address - Phone:937-378-7130
Mailing Address - Fax:937-378-7131
Practice Address - Street 1:864 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-8408
Practice Address - Country:US
Practice Address - Phone:937-378-7130
Practice Address - Fax:937-378-7131
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003689207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0645467Medicaid
H051831Medicare PIN