Healthcare Provider Details

I. General information

NPI: 1568239077
Provider Name (Legal Business Name): HYRUM SNELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 09/18/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 AMHERST ST SUITE 300
WINCHESTER VA
22601
US

IV. Provider business mailing address

326 CHELTENHAM DR
STEPHENS CITY VA
22655-2333
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-6721
  • Fax: 540-536-6724
Mailing address:
  • Phone: 801-200-9612
  • Fax: 540-536-6724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: