Individual
VICTOR GONZALO VARGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204
(501) 666-2824
(501) 666-9653
Mailing address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 666-2824
(501) 666-9653
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
E5215
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165298001
—
AR
01
—
5N912C207
MEDICARE
AR
Enumeration date
03/09/2007
Last updated
07/06/2018
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