Provider Demographics
NPI:1891737581
Name:SNELL, JOY A (MD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:A
Last Name:SNELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 DAUN
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-8508
Mailing Address - Country:US
Mailing Address - Phone:580-536-7400
Mailing Address - Fax:580-536-7402
Practice Address - Street 1:5405 DAUN
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8508
Practice Address - Country:US
Practice Address - Phone:580-536-7400
Practice Address - Fax:580-536-7402
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19309207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
751465559004OtherBCBS (APPA)
OK200109400AMedicaid
OK100187740AMedicaid
751465559004OtherBCBS (APPA)
OK249347301Medicare PIN
OK$$$$$$$$$002OtherBCBS (ADV PATH)
OK248429010Medicare PIN