Basic Information
Provider Information
NPI: 1932562923
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNOOK
FirstName: LINDSAY
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 517 SEBRING DR
Address2:  
City: BELMONT
State: NC
PostalCode: 280128874
CountryCode: US
TelephoneNumber: 4235340421
FaxNumber:  
Practice Location
Address1: 1225 E GARRISON BLVD
Address2:  
City: GASTONIA
State: NC
PostalCode: 280545115
CountryCode: US
TelephoneNumber: 7048657416
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/29/2016
LastUpdateDate: 06/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X2020-00241NCY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home