=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861474702
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JEFFREY SINGER, MD (APMC)
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/16/2005
-----------------------------------------------------
Last Update Date | 11/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4720 S I 10 SERVICE RD W SUITE 406
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70001-7404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-456-3155
-----------------------------------------------------
Fax | 504-456-3113
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4720 S I 10 SERVICE RD W SUITE 406
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70001-7404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-456-3155
-----------------------------------------------------
Fax | 504-456-3113
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MRS. COLINDA BREAUX GAUTHREAUX
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 504-456-3155
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | MD.10414R
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------