Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME81538 | FL |
N | 207YS0123X | Facial Plastic Surgeon | ME81538 | FL |
NPI | 1376545152 |
---|---|
Provider Name | Robert Todd Snowden |
First Address | Jacksonville, FL 32203-1113 |
Second Address | Jacksonville, FL 32258-5473 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 18/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0046297-00 | (05) | FL |
G49115 | (02) | |
P00997636 | RAILROAD MEDICARE (01) | FL |