Provider Demographics
NPI:1629054275
Name:LITTLE, JAMES CONRAD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CONRAD
Last Name:LITTLE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1008 NC 62 E
Mailing Address - Street 2:
Mailing Address - City:CLIMAX
Mailing Address - State:NC
Mailing Address - Zip Code:27233
Mailing Address - Country:US
Mailing Address - Phone:336-674-8237
Mailing Address - Fax:336-674-8968
Practice Address - Street 1:1008 NC 62 E
Practice Address - Street 2:
Practice Address - City:CLIMAX
Practice Address - State:NC
Practice Address - Zip Code:27233
Practice Address - Country:US
Practice Address - Phone:336-674-8237
Practice Address - Fax:336-674-8968
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC15968207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCDG8098OtherRAILROAD MEDICARE
NC7901027Medicaid
NC7901027Medicaid
NCC85183Medicare UPIN