| Doctor Name: | BRETT T SNODGRASS |
| NPI Number: | 1760696918 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 2008015989 |
| Business Practice Address: | 1 Southtowne Dr. Great Mines Health Center Potosi, MO - 63664 |
| Business Phone Number: | 5734389355 |
| Business Fax Number: | |
| Mailing Address: | 100a Kenrick Plaza, Julie Thomas ST. LOUIS |
| State: | MO |
| Postal Code: | 631194416 |
| Phone Number: | 3149680076 |
| Fax Number: | 3149686883 |
| NPI Enumeration Date: | 05/09/2007 |
| NPI Last Update Date: | 09/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2008015989 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |