Provider Demographics
NPI:1033295894
Name:SNODGRASS, PATTI LYNN (MD)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:LYNN
Last Name:SNODGRASS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:281 SAWYER DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-3409
Mailing Address - Country:US
Mailing Address - Phone:970-259-2162
Mailing Address - Fax:970-247-5255
Practice Address - Street 1:281 SAWYER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-3409
Practice Address - Country:US
Practice Address - Phone:970-259-2162
Practice Address - Fax:970-247-5255
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO409932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH39050Medicare UPIN