Provider Demographics
NPI:1922086990
Name:LITTON PATHOLOGY ASSOCIATED PC
Entity Type:Organization
Organization Name:LITTON PATHOLOGY ASSOCIATED PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:LITTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-229-6449
Mailing Address - Street 1:700 NW HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-7730
Mailing Address - Country:US
Mailing Address - Phone:816-229-6449
Mailing Address - Fax:816-224-4206
Practice Address - Street 1:700 NW HUNTER DR
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-7730
Practice Address - Country:US
Practice Address - Phone:816-229-6449
Practice Address - Fax:816-224-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1618207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
04797110OtherBLUE CROSS
MO702807207Medicaid
C230000AMedicare ID - Type Unspecified