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General NPI Number Information
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NPI Number | 1104817683
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Entity Type | Individual
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Provider Name | JAMES DANIEL SNIPES M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 12/14/2009
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Provider Practice Location Address
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Address Line | 104 BROADWAY PL
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City | ANAMOSA
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State | IA
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Zip | 52205-1100
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Country | US
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Telephone | 319-462-6131
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Fax |
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Provider Business Mailing Address
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Address Line | 65 TARTAN DR
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-8002
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Country | US
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Telephone | 319-929-0741
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35320
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License Number State | IA
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