Provider Demographics
NPI:1245538446
Name:VARGO, ABIGAIL (MD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:VARGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 D ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365
Mailing Address - Country:US
Mailing Address - Phone:928-328-2666
Mailing Address - Fax:928-328-3838
Practice Address - Street 1:990 D ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-9484
Practice Address - Country:US
Practice Address - Phone:928-328-2666
Practice Address - Fax:928-328-3838
Is Sole Proprietor?:No
Enumeration Date:2011-03-11
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252339208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice