Healthcare Provider Details

I. General information

NPI: 1477521987
Provider Name (Legal Business Name): CHRIS A. VARVA D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 06/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2168 S LAMAR BLVD PRACTICE LOCATION-NOT MAILING ADDRESS
OXFORD MS
38655-5224
US

IV. Provider business mailing address

1001 S LAKE CV
OXFORD MS
38655-9211
US

V. Phone/Fax

Practice location:
  • Phone: 662-832-3338
  • Fax: 888-371-8341
Mailing address:
  • Phone: 662-832-3338
  • Fax: 888-371-8341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1309
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number80190
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: