Provider Demographics
NPI:1306845177
Name:LITTLEFIELD, WILLIAM GLENN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GLENN
Last Name:LITTLEFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8450 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46278-1381
Mailing Address - Country:US
Mailing Address - Phone:173-802-2000
Mailing Address - Fax:317-802-2170
Practice Address - Street 1:8450 NORTHWEST BLVD STE 4500
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46278-1381
Practice Address - Country:US
Practice Address - Phone:173-802-2000
Practice Address - Fax:317-802-2170
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064638G207XS0106X
IN01087287A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003115971Medicaid
GA003115971Medicaid