Provider Demographics
NPI:1194883827
Name:SINGLETON, KEVIN JAMES GARDNER (DIPLAC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:JAMES GARDNER
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:DIPLAC
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:GARDNER
Other - Last Name:SINGLETON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:13701 S DOBBS RD
Mailing Address - Street 2:
Mailing Address - City:MCLOUD
Mailing Address - State:OK
Mailing Address - Zip Code:74851-8471
Mailing Address - Country:US
Mailing Address - Phone:405-401-6380
Mailing Address - Fax:
Practice Address - Street 1:1117 NW 50TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4401
Practice Address - Country:US
Practice Address - Phone:405-401-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist