MEDICARE: DR. RONALD JAMES VARCAK D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2425	TN
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	2425	TN

General Provider Information

NPI Number	:	1013911577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD JAMES VARCAK D.O.

Provider Business Mailing Address
First Line	:	133 HAYES ST
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-8000
Country	:	US
Telephone Number	:	931-456-9434
Fax Number	:	931-456-5061

Provider Business Practice Location Address
First Line	:	133 HAYES ST
Second Line	:
City	:	CROSSVILLE
State	:	TN
Zip	:	38555-8000
Country	:	US
Telephone Number	:	931-456-9434
Fax Number	:	931-456-5061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	04/04/2014

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