Individual
DR. JACK ROBIN SNEDDEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10502 NORTH 110TH EAST AVENUE, OWASSO, OK 74055-6655
(918) 376-8590
(918) 376-8549
Mailing address
10502 N 110TH EAST AVE, OWASSO, OK 74055-6655
(918) 376-8590
(918) 376-8549
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
21312
OK
208M00000X
Hospitalist Physician
Primary
21312
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100120000A
—
OK
Enumeration date
01/30/2006
Last updated
05/06/2014
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