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General NPI Number Information
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NPI Number | 1528245479
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Entity Type | Organization
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Legal Business Name | PURA G VARGAS MD INC
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 38 EXECUTIVE DRIVE
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City | NORWALK
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State | OH
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Zip | 44857
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Country | US
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Telephone | 419-668-8881
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Fax | 419-668-0668
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Provider Business Mailing Address
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Address Line | 38 EXECUTIVE DRIVE
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City | NORWALK
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State | OH
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Zip | 44857
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Country | US
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Telephone | 419-668-8881
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Fax | 419-668-0668
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | PURA G VARGAS
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Credential | MD
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Telephone | 419-668-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 35032040
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 35032040
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License Number State | OH
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