Provider Demographics
NPI:1316227234
Name:ISSAC C SINGLETON PC
Entity Type:Organization
Organization Name:ISSAC C SINGLETON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF
Authorized Official - Prefix:DR
Authorized Official - First Name:ISSAC
Authorized Official - Middle Name:C
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-362-3937
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV311152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU78970Medicare UPIN