Individual
DR. CLYDE R VARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 AINSWORTH DR, SUITE A, PRESCOTT, AZ 86301-1613
(928) 778-0827
(928) 778-5622
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(928) 759-5874
(928) 458-2039
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
08710R
LA
2084N0400X
Neurology Physician
Primary
42061
AZ
2084N0400X
Neurology Physician
9981
AL
2084V0102X
Vascular Neurology Physician
38948
OK
2084V0102X
Vascular Neurology Physician
42061
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009913762
—
AL
01
—
0101241480
LICENSE
VA
05
—
09429053
—
MS
05
—
101165
—
AL
05
—
201051630A
—
OK
01
—
51545992
BCBS- 3401 MEDICAL PK DR
AL
01
—
51547299
BCBS - 575 STANTON RD
AL
Enumeration date
09/07/2005
Last updated
12/19/2023
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