Provider Demographics
NPI:1225544323
Name:SNOW, DONALD J JR (DAOM)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:SNOW
Suffix:JR
Gender:M
Credentials:DAOM
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:643 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5726
Mailing Address - Country:US
Mailing Address - Phone:337-475-6334
Mailing Address - Fax:337-475-6327
Practice Address - Street 1:643 DR MICHAEL DEBAKEY DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5726
Practice Address - Country:US
Practice Address - Phone:337-475-6334
Practice Address - Fax:337-475-6327
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAACA.200009171100000X, 2081P2900X
LA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No171100000XOther Service ProvidersAcupuncturist