MEDICARE: MR. MICHAEL JAI SINGH MD

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	208D00000X	General Practice Physician	E1203	AR

General Provider Information

NPI Number	:	1972596542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL JAI SINGH MD

Provider Business Mailing Address
First Line	:	PO BOX 851
Second Line	:
City	:	HAMPTON
State	:	AR
Zip	:	71744-0851
Country	:	US
Telephone Number	:	870-798-3515
Fax Number	:	870-798-2005

Provider Business Practice Location Address
First Line	:	211 NORTH MAIN
Second Line	:
City	:	AMITY
State	:	AR
Zip	:	71921-0218
Country	:	US
Telephone Number	:	870-798-3515
Fax Number	:	870-798-4100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	05/29/2015

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