Healthcare Provider Details

I. General information

NPI: 1730767807
Provider Name (Legal Business Name): JASRAJ SINGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JASRAJ SINGH MARJARA MD

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 S 6TH AVE
TUCSON AZ
85723-0001
US

IV. Provider business mailing address

PO BOX 245046
TUCSON AZ
85724-5046
US

V. Phone/Fax

Practice location:
  • Phone: 816-877-1364
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number71995
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number71995
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberR82262
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31697
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: