Provider Demographics
NPI:1972595445
Name:SNIDER, WILLIAM JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:SNIDER
Suffix:
Gender:M
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 992890
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-2890
Mailing Address - Country:US
Mailing Address - Phone:530-244-2663
Mailing Address - Fax:530-244-4309
Practice Address - Street 1:2160 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2530
Practice Address - Country:US
Practice Address - Phone:530-244-2663
Practice Address - Fax:530-244-4309
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC357690207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C357690Medicaid
CA00C357691Medicare PIN
CA00C357690Medicaid