Healthcare Provider Details

I. General information

NPI: 1114933249
Provider Name (Legal Business Name): LENA MAE SNYDER M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 OLD MADISON PIKE STE 690
HUNTSVILLE AL
35806-2198
US

IV. Provider business mailing address

6767 OLD MADISON PIKE STE 690
HUNTSVILLE AL
35806-2198
US

V. Phone/Fax

Practice location:
  • Phone: 800-955-1919
  • Fax: 270-442-6294
Mailing address:
  • Phone: 800-955-1919
  • Fax: 270-442-6294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number145820
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36292
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: