Provider Demographics
NPI:1821169269
Name:LITTELL, ROBERT S (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:LITTELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSHEAR
Mailing Address - State:GA
Mailing Address - Zip Code:31516-1824
Mailing Address - Country:US
Mailing Address - Phone:912-449-5599
Mailing Address - Fax:
Practice Address - Street 1:106 MAIN ST
Practice Address - Street 2:
Practice Address - City:BLACKSHEAR
Practice Address - State:GA
Practice Address - Zip Code:31516-1824
Practice Address - Country:US
Practice Address - Phone:912-449-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJDVMedicare ID - Type Unspecified