Basic Information
Provider Information | |||||||||
NPI: | 1275623639 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SINGLETON | ||||||||
FirstName: | CHARLES | ||||||||
MiddleName: | E. | ||||||||
NamePrefix: | MR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 110 S ANNISTON AVE | ||||||||
Address2: | STE. 110 | ||||||||
City: | SYLACAUGA | ||||||||
State: | AL | ||||||||
PostalCode: | 351502961 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2562070200 | ||||||||
FaxNumber: | 2562070201 | ||||||||
Practice Location | |||||||||
Address1: | 208 WEST SPRING STREET | ||||||||
Address2: | SUITE 300 | ||||||||
City: | SYLACAUGA | ||||||||
State: | AL | ||||||||
PostalCode: | 35150 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2562458100 | ||||||||
FaxNumber: | 2562459138 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/13/2006 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 00021506 | AL | Y |   | Allopathic & Osteopathic Physicians | Surgery |   |
No ID Information.