Provider Demographics
NPI:1063814556
Name:SINGLETARY, TYRONE
Entity Type:Individual
Prefix:MR
First Name:TYRONE
Middle Name:
Last Name:SINGLETARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 BYRUM DR
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-5752
Mailing Address - Country:US
Mailing Address - Phone:760-207-8564
Mailing Address - Fax:
Practice Address - Street 1:1601 HARMON DRIVE
Practice Address - Street 2:
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314
Practice Address - Country:US
Practice Address - Phone:912-767-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115107N2355A2700X
CA115107247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other