Doctor Name: | DR. RICHARD ALAN SNODGRASS |
NPI Number: | 1376535062 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4-22287 |
Business Practice Address: | 2200 Summerlon Cir Ste A Dodge City, KS - 678012905 |
Business Phone Number: | 6204089700 |
Business Fax Number: | 6204089701 |
Mailing Address: | 2200 Summerlon Cir Ste A, DODGE CITY |
State: | KS |
Postal Code: | 678012905 |
Phone Number: | 6204089700 |
Fax Number: | 6204089701 |
NPI Enumeration Date: | 08/18/2005 |
NPI Last Update Date: | 12/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4-22287 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |