Provider Demographics
NPI:1922073717
Name:SNOWDY, HARRY ADDISON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:ADDISON
Last Name:SNOWDY
Suffix:JR
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 1:3567 STEVENS WAY
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-9560
Mailing Address - Country:US
Mailing Address - Phone:706-951-0181
Mailing Address - Fax:
Practice Address - Street 1:3567 STEVENS WAY
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-9560
Practice Address - Country:US
Practice Address - Phone:706-951-0181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA#29107207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00332428BMedicaid
GA00332428BMedicaid