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NPI Code Detail

MEDICARE: GEORGIANNE M SNOWDEN MD

MEDICARE:   GEORGIANNE M SNOWDEN  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
12085R0202XDiagnostic Radiology Physician16539OK
22085R0204XVascular & Interventional Radiology Physician16539OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00171214OTHEROKRAILROAD MEDICARE /AI
3P00144996OTHEROKRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1881697761
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGIANNE M SNOWDEN MD
Provider Business Mailing Address
First Line : 3433 NW 56TH ST, SUITE C-40
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-4455
Country : US
Telephone Number : 405-945-4741
Fax Number : 888-972-5320
Provider Business Practice Location Address
First Line : 3433 NW 56TH ST, SUITE C-40
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-4455
Country : US
Telephone Number : 405-945-4741
Fax Number : 888-972-5320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 06/18/2021

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Directions to “ GEORGIANNE M SNOWDEN MD” Practice Location

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