Provider Demographics
NPI:1093716490
Name:BINDRA, GURPAL SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:GURPAL
Middle Name:SINGH
Last Name:BINDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1716 PARR AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-2073
Mailing Address - Country:US
Mailing Address - Phone:731-286-0149
Mailing Address - Fax:731-286-6956
Practice Address - Street 1:1716 PARR AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-2073
Practice Address - Country:US
Practice Address - Phone:731-286-0149
Practice Address - Fax:731-286-6956
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD21989174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
192526OtherBCBST
TN3725948OtherMEDICARE GROUP # WEST TN MEDICAL, PLLC
TN3730286OtherMEDICARE GROUP # RURAL HEALTH CLINICS OF WEST TN, PLLC
1750515532OtherGROUP NPI
TN3730286OtherMEDICAID GROUP # RURAL HEALTH CLINICS OF WEST TN, PLLC
TN3064931Medicaid
TN3725948OtherMEDICAID GROUP # WEST TN MEDICAL, PLLC
F12991Medicare UPIN
TN3725948OtherMEDICAID GROUP # WEST TN MEDICAL, PLLC
TN3725948OtherMEDICARE GROUP # WEST TN MEDICAL, PLLC