Provider Demographics
NPI:1992867402
Name:SNIPES, RYAN E (OD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:E
Last Name:SNIPES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:RANDLEMAN
Mailing Address - State:NC
Mailing Address - Zip Code:27317-1504
Mailing Address - Country:US
Mailing Address - Phone:336-337-1298
Mailing Address - Fax:
Practice Address - Street 1:200 W ACADEMY ST
Practice Address - Street 2:
Practice Address - City:RANDLEMAN
Practice Address - State:NC
Practice Address - Zip Code:27317-1504
Practice Address - Country:US
Practice Address - Phone:336-337-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1839152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCFH7000055OtherFIRST HEALTH
NC410034018OtherRRMC
NC0853510001OtherCIGNA GOVERNMENT SERVICES MEDICARE PART B DME
NC093HWOtherBLUE CROSS BLUE SHIELD
NC30624OtherOPTICARE
NC89093HWMedicaid
NCB5322OtherMEDCOST
NC0853510001OtherCIGNA GOVERNMENT SERVICES MEDICARE PART B DME
NC30624OtherOPTICARE
NCFH7000055OtherFIRST HEALTH
NC410034018OtherRRMC