Provider Demographics
NPI:1013932003
Name:SNELL, WILLIAM EDWARD (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:EDWARD
Last Name:SNELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:880 CANTON RD NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7283
Mailing Address - Country:US
Mailing Address - Phone:770-590-0585
Mailing Address - Fax:770-428-4087
Practice Address - Street 1:880 CANTON RD NE
Practice Address - Street 2:SUITE 300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7283
Practice Address - Country:US
Practice Address - Phone:770-590-0585
Practice Address - Fax:770-428-4087
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA024495207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000273391AMedicaid
080021481OtherRAILROAD MEDICARE
080021481OtherRAILROAD MEDICARE
GA000273391AMedicaid