Provider Demographics
NPI:1073834305
Name:SNODGRASS, EMILY KATHLEEN (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KATHLEEN
Last Name:SNODGRASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-662-6500
Mailing Address - Fax:
Practice Address - Street 1:1 MERCY LN
Practice Address - Street 2:SUITE 506
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913
Practice Address - Country:US
Practice Address - Phone:501-622-6500
Practice Address - Fax:501-622-6575
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101254010207Q00000X
AR9034207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine