Provider Demographics
NPI:1487898797
Name:BARJINDER SINGH,MD
Entity type:Organization
Organization Name:BARJINDER SINGH,MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KNOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-283-6240
Mailing Address - Street 1:1706 ALICE ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-5216
Mailing Address - Country:US
Mailing Address - Phone:912-283-6240
Mailing Address - Fax:912-283-7108
Practice Address - Street 1:165 E TOLLISON STREET
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513
Practice Address - Country:US
Practice Address - Phone:912-283-6240
Practice Address - Fax:912-283-7108
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH GEORGIA ONCOLOGY HEMATOLGY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-30
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039236174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00764717DMedicaid
GA00764717DMedicaid