Provider Demographics
NPI:1962560227
Name:SNOKE FAMILY PRACTICE INC.
Entity type:Organization
Organization Name:SNOKE FAMILY PRACTICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:SNOKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MBA
Authorized Official - Phone:717-737-3465
Mailing Address - Street 1:1800 CARLISLE RD
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-5909
Mailing Address - Country:US
Mailing Address - Phone:717-737-3465
Mailing Address - Fax:717-737-8561
Practice Address - Street 1:1800 CARLISLE RD
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-5909
Practice Address - Country:US
Practice Address - Phone:717-737-3465
Practice Address - Fax:717-737-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006241L207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014007040004Medicaid
PACF3288OtherRAILROAD MEDICARE
PAB41681Medicare UPIN
PA532681Medicare PIN