Healthcare Provider Details

I. General information

NPI: 1124327549
Provider Name (Legal Business Name): CHRISTOPHER L SNYDER PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2011
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 N HIGHLAND PARK AVE
CHATTANOOGA TN
37404-2016
US

IV. Provider business mailing address

455 N HIGHLAND PARK AVE
CHATTANOOGA TN
37404-2016
US

V. Phone/Fax

Practice location:
  • Phone: 423-209-6070
  • Fax: 423-209-6071
Mailing address:
  • Phone: 423-209-6070
  • Fax: 423-209-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1938
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: