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NPI Code Detail

MEDICARE: CATHERINE J VARNUM O.D.

MEDICARE: CATHERINE J VARNUM 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
1152W00000XOptometristOPT754ME

General Provider Information

NPI Number : 1205915618
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE J VARNUM O.D.
Provider Business Mailing Address
First Line : 131 ACADEMY ST
Second Line :
City : PRESQUE ISLE
State : ME
Zip : 04769-3101
Country : US
Telephone Number : 207-764-1900
Fax Number : 207-764-4900
Provider Business Practice Location Address
First Line : 131 ACADEMY ST
Second Line :
City : PRESQUE ISLE
State : ME
Zip : 04769-3101
Country : US
Telephone Number : 207-764-1900
Fax Number : 207-764-4900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2006
Last Update Date : 02/26/2008

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