Organization
EXECUTIVE DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIRNJOT SINGH MD (PRESIDENT)
(219) 395-0667
Entity
Organization
Contact information
Practice address
5455 EXECUTIVE PL STE B, JACKSON, MS 39206-4104
(219) 395-0667
Mailing address
10996 FOUR SEASONS PL STE 100A, CROWN POINT, IN 46307-8685
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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