Provider Demographics
NPI:1871053264
Name:SNYDER, KENNETH WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:WILLIAM
Last Name:SNYDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E 2ND ST STE 1230
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1587
Mailing Address - Country:US
Mailing Address - Phone:775-312-6315
Mailing Address - Fax:
Practice Address - Street 1:625 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2215
Practice Address - Country:US
Practice Address - Phone:775-553-0476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO3346207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology