1487898797 NPI number — BARJINDER SINGH,MD

Table of content: (NPI 1487898797)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487898797 NPI number — BARJINDER SINGH,MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARJINDER SINGH,MD
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:
SOUTH GEORGIA ONCOLOGY HEMATOLOGY CENTER
Provider Other Organization Name Type Code:
3
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:
1487898797
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1706 ALICE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAYCROSS
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31501-5216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
912-283-6240
Provider Business Mailing Address Fax Number:
912-283-7108

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
165 E TOLLISON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAXLEY
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
912-283-6240
Provider Business Practice Location Address Fax Number:
912-283-7108
Provider Enumeration Date:
04/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
KNOWLES
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
912-283-6240

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  039236 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00764717D , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".




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