Healthcare Provider Details

I. General information

NPI: 1780002659
Provider Name (Legal Business Name): JAMES D VARGO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8404 INDIAN HILLS DR FL 2
OMAHA NE
68114-4041
US

IV. Provider business mailing address

8404 INDIAN HILLS DR FL 2
OMAHA NE
68114-4041
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-7871
  • Fax:
Mailing address:
  • Phone: 402-955-7871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number33681
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: