Provider Demographics
NPI:1003956418
Name:SNOW, JAY M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:M
Last Name:SNOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 270419
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-0419
Mailing Address - Country:US
Mailing Address - Phone:314-366-4874
Mailing Address - Fax:
Practice Address - Street 1:1400 HWY 61 S
Practice Address - Street 2:G-50
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028
Practice Address - Country:US
Practice Address - Phone:314-366-4874
Practice Address - Fax:314-366-4875
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2011030112208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery