Provider Demographics
NPI:1427033687
Name:SINGH, JASON (OD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3526 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1410
Mailing Address - Country:US
Mailing Address - Phone:513-533-1926
Mailing Address - Fax:
Practice Address - Street 1:5112 CEDAR VILLAGE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3717
Practice Address - Country:US
Practice Address - Phone:513-770-4220
Practice Address - Fax:513-770-4120
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4969T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000345092OtherANTHEM
OH4969ODOtherHUMANA
OH2071967Medicaid
OH000000345092OtherANTHEM
OH5532460001Medicare NSC
OH0877988Medicare PIN