Healthcare Provider Details

I. General information

NPI: 1497197859
Provider Name (Legal Business Name): AMANDEEP SINGH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HIGHWAY 15 N STE D
LAUREL MS
39440-1983
US

IV. Provider business mailing address

PO BOX 247
LAUREL MS
39441-0247
US

V. Phone/Fax

Practice location:
  • Phone: 601-601-4269
  • Fax: 601-399-6281
Mailing address:
  • Phone: 601-426-9614
  • Fax: 601-399-6281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number24728
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: