Provider Demographics
NPI:1407200207
Name:SINGLETON AND MYRICK INCORPORATED
Entity Type:Organization
Organization Name:SINGLETON AND MYRICK INCORPORATED
Other - Org Name:BUCKNER PROSTHETIC AND ORTHOTIC LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:601-944-1130
Mailing Address - Street 1:2089 LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-5010
Mailing Address - Country:US
Mailing Address - Phone:601-944-1130
Mailing Address - Fax:601-355-7476
Practice Address - Street 1:20 PARKWAY BLVD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-8879
Practice Address - Country:US
Practice Address - Phone:601-366-4687
Practice Address - Fax:601-336-6782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier