Basic Information
Provider Information
NPI: 1275573974
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGER
FirstName: GARY
MiddleName: DUANE
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 633819
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452630001
CountryCode: US
TelephoneNumber: 8652923000
FaxNumber:  
Practice Location
Address1: 2300 PATTERSON ST
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372031538
CountryCode: US
TelephoneNumber: 6153421000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/08/2006
LastUpdateDate: 11/07/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X01220TNY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
P0038435701TNRAILROAD MEDICAREOTHER
308161801TNBLUECROSSOTHER
20627530705MO MEDICAID
330505305TN MEDICAID
415153501TNBLUECROSSOTHER
P0073360001MORAILROAD MEDICAREOTHER
330505405TN MEDICAID
6486837505KY MEDICAID


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