Basic Information
Provider Information
NPI: 1538424973
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: JAYSINGH
MiddleName: RAMPRASAD
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 ACKERMAN RD STE 2120
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432021559
CountryCode: US
TelephoneNumber: 6142934969
FaxNumber: 6142936111
Practice Location
Address1: 2050 KENNY RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432213502
CountryCode: US
TelephoneNumber: 6142934969
FaxNumber: 6142936111
Other Information
ProviderEnumerationDate: 07/11/2012
LastUpdateDate: 03/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X35130590OHY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

ID Information
IDTypeStateIssuerDescription
030048005OH MEDICAID


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