Provider Demographics
NPI:1285607432
Name:JOHN E SINGLETARY JR
Entity type:Organization
Organization Name:JOHN E SINGLETARY JR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SINGLETARY
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:318-346-2682
Mailing Address - Street 1:PO BOX 958
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-0958
Mailing Address - Country:US
Mailing Address - Phone:318-346-2682
Mailing Address - Fax:318-346-7315
Practice Address - Street 1:510 S COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1135
Practice Address - Country:US
Practice Address - Phone:318-346-2682
Practice Address - Fax:318-346-2682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA56048Medicare ID - Type Unspecified