Provider Demographics
NPI:1164591996
Name:SINGLETON, ISAAC C (O D)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:C
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 LINDELL RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5409
Mailing Address - Country:US
Mailing Address - Phone:702-362-3937
Mailing Address - Fax:702-362-7935
Practice Address - Street 1:2575 LINDELL RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5409
Practice Address - Country:US
Practice Address - Phone:702-362-3937
Practice Address - Fax:702-362-7935
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV311152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU78970Medicare UPIN
NVFO004XMedicare PIN
NVGROUP VWQBDMMedicare PIN