MEDICARE: SINGLETON AND MYRICK INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1780439646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINGLETON AND MYRICK INCORPORATED

Provider Business Mailing Address
First Line	:	2089 LAKELAND DR
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39216-5010
Country	:	US
Telephone Number	:	601-944-1130
Fax Number	:	601-355-7476

Provider Business Practice Location Address
First Line	:	8110 SUMMA AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-3419
Country	:	US
Telephone Number	:	601-944-1130
Fax Number	:	601-355-7476

Authorized Official
Title or Position	:	OWNER
Name	:	MR. STEPHEN SINGLETON
Credential	:
Telephone Number	:	601-944-1130

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	04/23/2024

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