Provider Demographics
NPI:1699838185
Name:SNEAD, RODNEY VAN (MD FAAFP FACEP)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:VAN
Last Name:SNEAD
Suffix:
Gender:M
Credentials:MD FAAFP FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 QUINTARD AVE
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36201-4619
Mailing Address - Country:US
Mailing Address - Phone:256-741-1339
Mailing Address - Fax:256-714-1356
Practice Address - Street 1:1325 QUINTARD AVE
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-4619
Practice Address - Country:US
Practice Address - Phone:256-741-1339
Practice Address - Fax:256-714-1356
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL860190207PE0004X
AL00008545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51509346OtherBLUE CROSS BLUE SHIELD
ALC72816Medicare UPIN
AL51509346OtherBLUE CROSS BLUE SHIELD