Provider Demographics
NPI:1699066449
Name:SNYDER, JONATHAN R (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:R
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3200 BURNET AVE
Mailing Address - Street 2:3 SOUTH, CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:513-929-0104
Mailing Address - Fax:513-929-4369
Practice Address - Street 1:2123 AUBURN AVE
Practice Address - Street 2:SUITE 524
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2906
Practice Address - Country:US
Practice Address - Phone:513-929-0104
Practice Address - Fax:513-929-4369
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH096973208600000X
OH35096973208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery