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MR. JOHN DOUGLAS SNOWDEN PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1629072160

Individual Registrant:
MR. JOHN DOUGLAS SNOWDEN PA-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1861 MAIN ST  SNEEDVILLE, TN 37869-3645 US
Tel: 423-733-2131  Fax: 423-733-1055

Contact information for business:
PO BOX 850  ROGERSVILLE, TN 37857-0850 US
Tel: 423-733-2061  Fax: 423-733-1965

Registration Information:
NPI: 1629072160
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
TN634

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBST4176065TN01
36672101TN05




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