Provider Demographics
NPI:1134381262
Name:THOMAS LITTLER O D INC
Entity type:Organization
Organization Name:THOMAS LITTLER O D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:LITTLER
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:740-592-3055
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-0459
Mailing Address - Country:US
Mailing Address - Phone:740-592-3055
Mailing Address - Fax:740-594-4908
Practice Address - Street 1:213 COLUMBUS RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1335
Practice Address - Country:US
Practice Address - Phone:740-592-3055
Practice Address - Fax:740-594-4908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2666/T544332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5228177Medicaid
OH5228177Medicaid
OH0175402Medicare PIN
0632470001Medicare NSC