Basic Information
| Provider Information | |||||||||
| NPI: | 1407850266 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SINGLETON | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | R. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SINGLETON | ||||||||
| OtherFirstName: | MARGARET | ||||||||
| OtherMiddleName: | R. | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 135 S GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | MARYVILLE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 644682053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707632139 | ||||||||
| FaxNumber: | 8707635056 | ||||||||
| Practice Location | |||||||||
| Address1: | 209 S LOCKARD ST | ||||||||
| Address2: | |||||||||
| City: | BLYTHEVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723152541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707632139 | ||||||||
| FaxNumber: | 8707635056 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2005 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 2002005859 | MO | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 205807506 | 05 | MO | MEDICAID |