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NPI Code Detail

MEDICARE: ROBIN L VARGO P.A.

MEDICARE:   ROBIN L VARGO  P.A.
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
1363AM0700XMedical Physician Assistant014421NY
2363A00000XPhysician AssistantPA07611TX
3363A00000XPhysician AssistantPA 60404079WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629378641
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBIN L VARGO P.A.
Provider Business Mailing Address
First Line : 1110 9TH AVE SW
Second Line :
City : PUYALLUP
State : WA
Zip : 98371-6736
Country : US
Telephone Number : 512-294-1170
Fax Number :
Provider Business Practice Location Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1303
Country : US
Telephone Number : 253-982-0328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2010
Last Update Date : 12/27/2013

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Directions to “ ROBIN L VARGO P.A.” Practice Location

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