Healthcare Provider Details

I. General information

NPI: 1245210657
Provider Name (Legal Business Name): JUDITH A. VARNAU D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

864 S MAIN ST
GEORGETOWN OH
45121-8408
US

IV. Provider business mailing address

7661 WHITE SWAN ROAD
GEORGETOWN OH
45121-9518
US

V. Phone/Fax

Practice location:
  • Phone: 937-378-7130
  • Fax: 937-378-7131
Mailing address:
  • Phone: 937-378-7130
  • Fax: 937-378-7131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34003689
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: