Provider Demographics
NPI:1508043860
Name:INDIRA SINGH MD, INC
Entity Type:Organization
Organization Name:INDIRA SINGH MD, INC
Other - Org Name:OKLAHOMA PEDIATRICS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:INDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-682-1656
Mailing Address - Street 1:1601 SW 89TH ST
Mailing Address - Street 2:BUILDING D, SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6349
Mailing Address - Country:US
Mailing Address - Phone:405-682-1656
Mailing Address - Fax:405-681-7467
Practice Address - Street 1:1601 SW 89TH ST
Practice Address - Street 2:BUILDING D, SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6349
Practice Address - Country:US
Practice Address - Phone:405-682-1656
Practice Address - Fax:405-681-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13683174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100058730BMedicaid
OK200111570AMedicaid
OK100736140AMedicaid
OK100058730AMedicaid