Provider Demographics
NPI:1831162692
Name:SINGLETARY, JOHN EDWARD II (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EDWARD
Last Name:SINGLETARY
Suffix:II
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 S COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-1135
Mailing Address - Country:US
Mailing Address - Phone:318-346-2682
Mailing Address - Fax:318-346-7315
Practice Address - Street 1:510 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1135
Practice Address - Country:US
Practice Address - Phone:318-346-2682
Practice Address - Fax:318-346-7315
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA56048Medicare ID - Type Unspecified