Healthcare Provider Details

I. General information

NPI: 1083636641
Provider Name (Legal Business Name): VINOD KUMAR SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10524 E HIGHWAY 92
HEREFORD AZ
85615-8371
US

IV. Provider business mailing address

101 COLE AVE
BISBEE AZ
85603-1327
US

V. Phone/Fax

Practice location:
  • Phone: 520-366-0300
  • Fax: 520-366-0440
Mailing address:
  • Phone: 520-432-6481
  • Fax: 520-432-5082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number22040
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number6695
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: