Healthcare Provider Details

I. General information

NPI: 1780681528
Provider Name (Legal Business Name): STANLEY O SNYDER JR. M.D., R.V.T
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 HARDING RD SUITE 525
NASHVILLE TN
37205-2013
US

IV. Provider business mailing address

356 24TH AVE N SUITE 300
NASHVILLE TN
37203-1514
US

V. Phone/Fax

Practice location:
  • Phone: 615-385-1547
  • Fax: 615-297-9161
Mailing address:
  • Phone: 615-292-5722
  • Fax: 615-346-6225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD26740
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: