Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 2011030112 | MO |
Y | 208600000X | Surgeon | 2011030112 | MO |
NPI | 1003956418 |
---|---|
Provider Name | Dr. Jay M Snow |
First Address | Saint Louis, MO 63127-0419 |
Second Address | Festus, MO 63028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 17/11/2021 |