Provider Demographics
NPI:1689617417
Name:SNYDER, NORMAN I (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:I
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4253 N CROSSOVER RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4593
Mailing Address - Country:US
Mailing Address - Phone:479-442-8577
Mailing Address - Fax:479-442-2563
Practice Address - Street 1:4253 N CROSSOVER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4593
Practice Address - Country:US
Practice Address - Phone:479-442-8577
Practice Address - Fax:479-442-2563
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR43622084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR55757OtherBLUE CROSS
AR13034000000OtherQUALCHOICE QCA
ARC86531Medicare UPIN
AR55757OtherBLUE CROSS