Provider Demographics
NPI:1770578338
Name:VARNER, JOHN A (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:VARNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:416 E MAUMEE ST
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-2015
Mailing Address - Country:US
Mailing Address - Phone:260-667-5131
Mailing Address - Fax:260-665-7803
Practice Address - Street 1:306 E MAUMEE ST STE 104
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-2035
Practice Address - Country:US
Practice Address - Phone:260-675-7885
Practice Address - Fax:260-667-5790
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN02005549A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN940040077OtherMEDICARE
IN300019836Medicaid
MI4731086Medicaid
MI4731086Medicaid