Healthcare Provider Details

I. General information

NPI: 1770987943
Provider Name (Legal Business Name): JAISINGH RAJPUT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4371 NARROW LANE RD SUITE 100
MONTGOMERY AL
36116-2971
US

IV. Provider business mailing address

9926 DOGWOOD CT
MONTGOMERY AL
36117-5604
US

V. Phone/Fax

Practice location:
  • Phone: 334-613-3680
  • Fax: 334-613-3685
Mailing address:
  • Phone: 205-253-3981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34893
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: