MEDICARE: KEVIN K. SNYDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0802X	Addiction Psychiatry Physician	41126	CO
2	2084P0800X	Psychiatry Physician	41126	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013946706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN K. SNYDER MD

Provider Business Mailing Address
First Line	:	1115 ELKTON DR STE 300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-3597
Country	:	US
Telephone Number	:	719-373-9703
Fax Number	:	719-631-7017

Provider Business Practice Location Address
First Line	:	1115 ELKTON DR STE 300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-3597
Country	:	US
Telephone Number	:	719-373-9703
Fax Number	:	719-631-7017

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	01/04/2018

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