Provider Demographics
NPI:1851524813
Name:LITTLEFIELD, PAUL RICHARD (BOARD CERTIFIED HEAR)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:RICHARD
Last Name:LITTLEFIELD
Suffix:
Gender:M
Credentials:BOARD CERTIFIED HEAR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 E 2100 S
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105-3724
Mailing Address - Country:US
Mailing Address - Phone:801-485-1441
Mailing Address - Fax:801-485-1480
Practice Address - Street 1:1441 E 2100 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-3724
Practice Address - Country:US
Practice Address - Phone:801-485-1441
Practice Address - Fax:801-485-1480
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT100897-4601237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT87-0239423003Medicaid