Healthcare Provider Details

I. General information

NPI: 1023377272
Provider Name (Legal Business Name): JOSHUA MORGAN VARNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3104 BLUE LAKE DR STE 110
VESTAVIA AL
35243-2372
US

IV. Provider business mailing address

3104 BLUE LAKE DR STE 110
VESTAVIA AL
35243-2372
US

V. Phone/Fax

Practice location:
  • Phone: 205-977-1949
  • Fax:
Mailing address:
  • Phone: 205-977-1949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number32790
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: