Individual
EUGENIO FORTUNATO VARGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 W JACKSON ST STE 400, CARBONDALE, IL 62901-1474
(618) 351-4972
(618) 351-4973
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036138518
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3053683
—
TN
Enumeration date
10/20/2005
Last updated
09/28/2021
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