MEDICARE: JOHN L SNELL III DO

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	207R00000X	Internal Medicine Physician	02838	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0413542	OTHER		CIGNA/NORTON
2	096990	OTHER		SIHO/NORTON
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	P00626228	OTHER	KY	RAILROAD-NCMA
5	0000557851	OTHER		ANTHEM/NORTON

General Provider Information

NPI Number	:	1275528739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN L SNELL III DO

Provider Business Mailing Address
First Line	:	10614 MEETING ST UNIT 101
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-5524
Country	:	US
Telephone Number	:	502-803-2984
Fax Number	:	502-829-8321

Provider Business Practice Location Address
First Line	:	10614 MEETING ST UNIT 101
Second Line	:
City	:	PROSPECT
State	:	KY
Zip	:	40059-5524
Country	:	US
Telephone Number	:	502-803-2984
Fax Number	:	502-829-8321

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	01/30/2026

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Directions to “ JOHN L SNELL III DO” Practice Location

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