Healthcare Provider Details

I. General information

NPI: 1447369590
Provider Name (Legal Business Name): ROBERT CRAVEN SNYDER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2508 PELHAM PKWY
PELHAM AL
35124-1321
US

IV. Provider business mailing address

2508 PELHAM PKWY
PELHAM AL
35124-1321
US

V. Phone/Fax

Practice location:
  • Phone: 205-664-0880
  • Fax: 205-664-0895
Mailing address:
  • Phone: 205-664-0880
  • Fax: 205-664-0895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00012143
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: