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NPI Code Detail

MEDICARE: RILEY J SNOOK MD

MEDICARE: RILEY J SNOOK 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
12084N0400XNeurology Physician01053264AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00754049OTHERINRAILROAD MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number : 1407854045
Entity Type Code : Individual
Provider Name (Legal Business Name) : RILEY J SNOOK MD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11725 ILLINOIS ST
Second Line :
City : CARMEL
State : IN
Zip : 46032-3008
Country : US
Telephone Number : 317-948-5450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 03/11/2025

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Directions to “ RILEY J SNOOK MD” Practice Location

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