Provider Demographics
NPI:1942283932
Name:JIMINEZ, STEPHANIE SNYDER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:SNYDER
Last Name:JIMINEZ
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 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL239652085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051550538Medicaid
AL114184Medicaid
AL117457Medicaid
AL136330Medicaid
AL253218Medicaid
AL51595577OtherBCBS
AL109901Medicaid
AL211912Medicaid
AL228274Medicaid
AL248459Medicaid
AL117547Medicaid
AL126726Medicaid
AL159747Medicaid
AL247825Medicaid
AL009961090Medicaid
AL228372Medicaid
AL51595575OtherBCBS
AL139781Medicaid
AL51550538OtherBCBS OF AL
AL51595574OtherBCBS
AL009942879Medicaid
AL009961100Medicaid
AL146036Medicaid
AL226999Medicaid
AL247708Medicaid
AL51550538Medicaid
AL51595576OtherBCBS
AL009911001Medicaid
AL228836Medicaid
AL009961110Medicaid
AL128161Medicaid
AL248361Medicaid
AL51100054OtherBCBS
AL51596729OtherBCBS