Healthcare Provider Details

I. General information

NPI: 1780439646
Provider Name (Legal Business Name): SINGLETON AND MYRICK INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2024
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 SUMMA AVE
BATON ROUGE LA
70809-3419
US

IV. Provider business mailing address

2089 LAKELAND DR
JACKSON MS
39216-5010
US

V. Phone/Fax

Practice location:
  • Phone: 601-944-1130
  • Fax: 601-355-7476
Mailing address:
  • Phone: 601-944-1130
  • Fax: 601-355-7476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN SINGLETON
Title or Position: OWNER
Credential:
Phone: 601-944-1130