Healthcare Provider Details

I. General information

NPI: 1225279698
Provider Name (Legal Business Name): DURGA SINGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2495 SHREVEPORT HWY # 71 DEPT OF RADIOLOGY
PINEVILLE LA
71360-4044
US

IV. Provider business mailing address

2495 SHREVEPORT HWY # 71 DEPT OF RADIOLOGY
PINEVILLE LA
71360-4044
US

V. Phone/Fax

Practice location:
  • Phone: 318-466-2306
  • Fax: 318-481-5055
Mailing address:
  • Phone: 318-466-2306
  • Fax: 318-481-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD207346
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: