Provider Demographics
NPI:1871887653
Name:SINGLETON, STEPHEN JAMES (CP)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JAMES
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLD RIVER PL
Mailing Address - Street 2:SUITE D
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-3435
Mailing Address - Country:US
Mailing Address - Phone:601-201-5521
Mailing Address - Fax:601-355-7476
Practice Address - Street 1:2 OLD RIVER PL
Practice Address - Street 2:SUITE D
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-3435
Practice Address - Country:US
Practice Address - Phone:601-201-5521
Practice Address - Fax:601-355-7476
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1501224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist