Provider Demographics
NPI:1528214558
Name:VINOD K. SINGH,MD,PC
Entity Type:Organization
Organization Name:VINOD K. SINGH,MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:928-757-2050
Mailing Address - Street 1:1739 BEVERLY AVENUE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-3593
Mailing Address - Country:US
Mailing Address - Phone:928-757-2050
Mailing Address - Fax:928-757-2401
Practice Address - Street 1:1739 E BEVERLY AVE STE 206
Practice Address - Street 2:
Practice Address - City:KINGMAN
Practice Address - State:AZ
Practice Address - Zip Code:86409-3593
Practice Address - Country:US
Practice Address - Phone:928-757-2050
Practice Address - Fax:928-757-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22040207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZF17787Medicare UPIN
AZZMD22040Medicare PIN