Provider Demographics
NPI:1356310536
Name:SINGH, JATINDER (MD)
Entity Type:Individual
Prefix:
First Name:JATINDER
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 MATTHEW DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:MS
Mailing Address - Zip Code:39367-2553
Mailing Address - Country:US
Mailing Address - Phone:601-735-2281
Mailing Address - Fax:601-735-2281
Practice Address - Street 1:920 MATTHEW DR
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:MS
Practice Address - Zip Code:39367-2553
Practice Address - Country:US
Practice Address - Phone:601-735-2281
Practice Address - Fax:601-735-2281
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10791207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00016697Medicaid
MS930002928Medicare ID - Type Unspecified
B30336Medicare UPIN