Provider Demographics
NPI:1124000344
Name:SNOW, RUTH DARR (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:DARR
Last Name:SNOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 S 4TH ST
Mailing Address - Street 2:ATTN: ALYCE RALEY
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5223
Mailing Address - Country:US
Mailing Address - Phone:256-549-0008
Mailing Address - Fax:256-549-0401
Practice Address - Street 1:820 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5223
Practice Address - Country:US
Practice Address - Phone:256-549-0008
Practice Address - Fax:256-549-0401
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2014-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL135072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E20860Medicare UPIN
AL009951020Medicaid
GAP00206200OtherTRAVELERS RR M/C SYLACAUG
AL51000182OtherBC SYLACAUGA
AL51099343OtherBC MONTCLAIR ROAD
AL51511823OtherBC 280
GA470001761OtherTRAVELERS RR M/C 280
GA470000833OtherTRAVELERS RR M/C MONTCLAI
AL51099342OtherBC GREYSTONE
AL009954970Medicaid
AL009933069Medicaid
GA470001757OtherTRAVELERS RR M/C SHELBY
GA47BBBJXMedicare ID - Type UnspecifiedGRIFFIN IMAGING
AL51503765OtherBC SHELBY
E20860Medicare UPIN
GA47BBBFQMedicare ID - Type UnspecifiedCOLUMBUS DIAGNOSTIC CENTE
AL009908825Medicaid
AL009973500Medicaid