Provider Demographics
NPI:1659319622
Name:ROBERT W SNYDER MD PHD PC
Entity Type:Organization
Organization Name:ROBERT W SNYDER MD PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:520-327-2020
Mailing Address - Street 1:4711 E CAMP LOWELL DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1256
Mailing Address - Country:US
Mailing Address - Phone:520-327-2020
Mailing Address - Fax:520-881-4396
Practice Address - Street 1:4711 E CAMP LOWELL DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1256
Practice Address - Country:US
Practice Address - Phone:520-327-2020
Practice Address - Fax:520-881-4396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17708207W00000X
AK3809207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5007084OtherAENTA
AZ0756530OtherBCROSS
D37677Medicare UPIN
AKK160813Medicare PIN
AZ5007084OtherAENTA
AZZ80448Medicare ID - Type Unspecified
AKK160809Medicare PIN