Healthcare Provider Details

I. General information

NPI: 1396427365
Provider Name (Legal Business Name): MRS. KATIE SNYDER FOLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KATIE ANN SNYDER

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3736 MIKE PADGETT HWY STE A
AUGUSTA GA
30906-0720
US

IV. Provider business mailing address

3736 MIKE PADGETT HWY STE A
AUGUSTA GA
30906-0720
US

V. Phone/Fax

Practice location:
  • Phone: 706-560-2273
  • Fax: 706-560-0903
Mailing address:
  • Phone: 706-560-2273
  • Fax: 706-560-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11935
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: