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Individual

DEREK VARNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
735 NORMAN DR # DR3, LEBANON, PA 17042-7559
(717) 270-7908
(717) 272-1734
Mailing address
420 S JACKSON ST, POTTSVILLE, PA 17901-3625
(570) 621-5000
(570) 621-5589

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA051903
PA
363A00000X
Physician Assistant
OA004216
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA051903
PA LICENSE NUMBER
PA
Enumeration date
04/19/2011
Last updated
01/29/2018
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