Provider Demographics
NPI:1124151857
Name:KRISHNA R. SINGH MD APMC
Entity type:Organization
Organization Name:KRISHNA R. SINGH MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-686-5255
Mailing Address - Street 1:6047 FIVE OAKS DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2596
Mailing Address - Country:US
Mailing Address - Phone:318-686-5255
Mailing Address - Fax:318-686-5239
Practice Address - Street 1:6047 FIVE OAKS DR
Practice Address - Street 2:SUITE D
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2596
Practice Address - Country:US
Practice Address - Phone:318-686-5255
Practice Address - Fax:318-686-5239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09508R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1444065Medicaid
LA1444065Medicaid