Organization
EJ SNYDER MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL JAY SNYDER MD (OWNER)
(770) 487-0029
Entity
Organization
Contact information
Practice address
525 WESTPARK DR, SUITE 100, PEACHTREE CITY, GA 30269-1575
(770) 487-0029
(770) 692-0116
Mailing address
525 WESTPARK DR, SUITE 100, PEACHTREE CITY, GA 30269-1575
(770) 487-0029
(770) 692-0116
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
55703
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
772905252C
—
GA
Enumeration date
12/10/2010
Last updated
12/10/2010
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