MEDICARE: DR. TIMOTHY E. SNELL M.D.

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	207L00000X	Anesthesiology Physician	L9491	TX

General Provider Information

NPI Number	:	1093774341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY E. SNELL M.D.

Provider Business Mailing Address
First Line	:	3385 POTOMAC WAY
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4978
Country	:	US
Telephone Number	:	208-522-7246
Fax Number	:	208-529-2620

Provider Business Practice Location Address
First Line	:	150 VISTA DR
Second Line	:
City	:	POCATELLO
State	:	ID
Zip	:	83201-5824
Country	:	US
Telephone Number	:	208-232-7246
Fax Number	:	208-529-2620

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	02/16/2026

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