MEDICARE: DR. JEFFREY L VARNER O.D.

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	152W00000X	Optometrist	PA-6648-T	PA

General Provider Information

NPI Number	:	1033256649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY L VARNER O.D.

Provider Business Mailing Address
First Line	:	116 S MAIN ST
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-2833
Country	:	US
Telephone Number	:	215-699-2020
Fax Number	:	215-699-2020

Provider Business Practice Location Address
First Line	:	116 S MAIN ST
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-2833
Country	:	US
Telephone Number	:	215-699-2020
Fax Number	:	215-699-2020

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	04/11/2011

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