Basic Information
Provider Information
NPI: 1649664228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: JATINDER
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 CORPORATE BLVD
Address2:  
City: LAFAYETTE
State: LA
PostalCode: 705083870
CountryCode: US
TelephoneNumber: 8008939698
FaxNumber:  
Practice Location
Address1: 1 MEDICAL PARK
Address2:  
City: WHEELING
State: WV
PostalCode: 26003
CountryCode: US
TelephoneNumber: 3042433000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2015
LastUpdateDate: 08/02/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X28394WVN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000X35.136235OHY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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