Provider Demographics
NPI:1194048959
Name:DRS SNIVELY AND GILDNER PC
Entity type:Organization
Organization Name:DRS SNIVELY AND GILDNER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:GILDNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:641-444-3380
Mailing Address - Street 1:307 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BELMOND
Mailing Address - State:IA
Mailing Address - Zip Code:50421-1124
Mailing Address - Country:US
Mailing Address - Phone:641-444-3380
Mailing Address - Fax:
Practice Address - Street 1:307 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BELMOND
Practice Address - State:IA
Practice Address - Zip Code:50421-1124
Practice Address - Country:US
Practice Address - Phone:641-444-3380
Practice Address - Fax:641-444-3929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1773152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0326680001Medicare NSC
IAI7737Medicare PIN