Provider Demographics
NPI:1386600351
Name:SINGH, JAGDEEP (MD)
Entity type:Individual
Prefix:DR
First Name:JAGDEEP
Middle Name:
Last Name:SINGH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 STATE HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OSAWATOMIE
Mailing Address - State:KS
Mailing Address - Zip Code:66064-1813
Mailing Address - Country:US
Mailing Address - Phone:913-755-7000
Mailing Address - Fax:
Practice Address - Street 1:500 STATE HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:OSAWATOMIE
Practice Address - State:KS
Practice Address - Zip Code:66064-1813
Practice Address - Country:US
Practice Address - Phone:913-755-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24664146D00000X
KS04-50388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-10478OtherBLUE CROSS OF AL PROV #
AL009993620Medicaid
AL009993620Medicaid
AL515-10478OtherBLUE CROSS OF AL PROV #