Provider Demographics
NPI:1972828820
Name:SNELLINGS, JOHN EARL (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EARL
Last Name:SNELLINGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-5955
Mailing Address - Fax:757-446-5196
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 118
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5955
Practice Address - Fax:757-446-5196
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252970207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1972828820Medicaid
VA1972828820OtherTRICARE/CHAMPUS
VA1972828820OtherUSA MANAGED CARE
1972828820OtherCORVEL
VA1972828820OtherMULTIPLAN
VA1972828820OtherVIRGINIA PREMIER HEALTH PLAN
VA1972828820OtherSEDGWICK CMS