Provider Demographics
NPI:1831144336
Name:KENNETHS S. SNOW, DO
Entity Type:Organization
Organization Name:KENNETHS S. SNOW, DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-955-1000
Mailing Address - Street 1:4800 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3499 N CAMPBELL AVE
Practice Address - Street 2:SUITE 907
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2376
Practice Address - Country:US
Practice Address - Phone:602-955-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty