1194784769 NPI number — PETER GRANT SINGER, M.D., P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194784769 NPI number — PETER GRANT SINGER, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PETER GRANT SINGER, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194784769
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 921
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
N LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72115-0921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-758-2588
Provider Business Mailing Address Fax Number:
501-758-2589

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
406 W 26TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
N LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72114-2125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-758-7588
Provider Business Practice Location Address Fax Number:
501-758-2589
Provider Enumeration Date:
03/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SINGER
Authorized Official First Name:
PETER
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
501-758-2588

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 118527002 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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