MEDICARE: THOMAS M SNYDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	ME55794	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750378311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS M SNYDER MD

Provider Business Mailing Address
First Line	:	PO BOX 746649
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6649
Country	:	US
Telephone Number	:	904-376-4400
Fax Number	:	904-391-5595

Provider Business Practice Location Address
First Line	:	1370 13TH AVE S STE 215
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-3206
Country	:	US
Telephone Number	:	904-249-1041
Fax Number	:	904-249-9764

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	06/14/2023

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Directions to “ THOMAS M SNYDER MD” Practice Location

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