MEDICARE: DR. FERRELL VARNER 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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	60460	TN

General Provider Information

NPI Number	:	1619321635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERRELL VARNER M.D.

Provider Business Mailing Address
First Line	:	920 MADISON AVE SECOND FLOOR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-3438
Country	:	US
Telephone Number	:	901-448-2302
Fax Number	:	901-448-1477

Provider Business Practice Location Address
First Line	:	920 MADISON AVE
Second Line	:	SUITE 447
City	:	MEMPHIS
State	:	TN
Zip	:	38163-3438
Country	:	US
Telephone Number	:	901-448-2302
Fax Number	:	901-448-1477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2016
Last Update Date	:	06/30/2020

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