Provider Demographics
NPI:1447220991
Name:SNUFFIN, WILLIAM JOHN JR (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:SNUFFIN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 11647
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-1647
Mailing Address - Country:US
Mailing Address - Phone:386-274-7800
Mailing Address - Fax:386-274-7801
Practice Address - Street 1:459 LOCUST AVE
Practice Address - Street 2:MB 26
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4808
Practice Address - Country:US
Practice Address - Phone:434-982-7150
Practice Address - Fax:434-982-7147
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102049895207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA166874OtherSOUTHERN HEALTH
VAP00192040OtherMEDICARE PIN
VA30642Medicaid
VA30642OtherCOMMUNITY HEALTH
VA169579OtherANTHEM SVC/HEALTHKEEPERS
VA169579OtherANTHEM SVC/HEALTHKEEPERS
VA30642OtherCOMMUNITY HEALTH
VAP00192040OtherMEDICARE PIN