Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QA0505X | Family Doctor - Adult Medicine | 12037 | OR |
Y | 207R00000X | Internist | 12037 | OR |
Y | 111NI0900X | Internist | 12037 | OR |
NPI | 1346202082 |
---|---|
Provider Name | David Snook |
First Address | Ashland, OR 97520-0009 |
Second Address | Ashland, OR 97520-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 08/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
023507000 | BC/BS OF OREGON (01) | OR |
191619 | (05) | OR |
8362923 | (05) | WA |
930079051 | RAILROAD MEDICARE (01) | |
97520A007 | CHAMPUS (01) | |
C93812 | (02) | |
C93812 | GROUP HEALTH (01) | |
C93812 | PROVIDENCE HEALTH PLAN (01) | |
XPY185105 | MEDI CAL (01) |