Individual
JAKODA SNIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 N ILLINOIS ST, INDIANAPOLIS, IN 46204
(317) 948-6161
Mailing address
1520 N SENATE AVE, INDIANAPOLIS, IN 46202-2213
(317) 962-0857
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01080589A
IN
207Q00000X
Family Medicine Physician
11018408A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11018408
IN
Other
Enumeration date
06/22/2015
Last updated
06/27/2018
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