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NPI Code Detail

MEDICARE: BEVERLY L VARGO M.D.

MEDICARE: BEVERLY L VARGO M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician2797364-1205UT

General Provider Information

NPI Number : 1316991565
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY L VARGO M.D.
Provider Business Mailing Address
First Line : 3467 EASTWOOD DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84109-3207
Country : US
Telephone Number : 801-492-1999
Fax Number : 801-492-1991
Provider Business Practice Location Address
First Line : 1912 W 930 N
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062-4104
Country : US
Telephone Number : 801-492-1999
Fax Number : 801-492-1991
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/08/2007

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Directions to “ BEVERLY L VARGO M.D.” Practice Location

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