Provider Demographics
NPI:1508034448
Name:RONALD H LITTLEFIELD M.D. LLC
Entity Type:Organization
Organization Name:RONALD H LITTLEFIELD M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LITTLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-582-8900
Mailing Address - Street 1:PO BOX 1798
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-1798
Mailing Address - Country:US
Mailing Address - Phone:864-582-8900
Mailing Address - Fax:
Practice Address - Street 1:319 N PINE ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-1605
Practice Address - Country:US
Practice Address - Phone:864-582-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6360207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890661JMedicaid
SC063601Medicaid
SC7907Medicare PIN
SCB92409Medicare UPIN