Provider Demographics
NPI:1598780660
Name:SINGH, DUSHYANT
Entity Type:Individual
Prefix:
First Name:DUSHYANT
Middle Name:
Last Name:SINGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12363 S 68TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-5887
Mailing Address - Country:US
Mailing Address - Phone:913-948-3935
Mailing Address - Fax:
Practice Address - Street 1:4200 E SKELLY DR STE 700
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3256
Practice Address - Country:US
Practice Address - Phone:918-438-7050
Practice Address - Fax:918-221-7544
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK40962207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty