Provider Demographics
NPI:1205807385
Name:LITTLE, RANDALL EUGENE (MD)
Entity type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:EUGENE
Last Name:LITTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:1120 S JACKSON HWY
Practice Address - Street 2:SUITE 204
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5777
Practice Address - Country:US
Practice Address - Phone:256-381-8811
Practice Address - Fax:256-381-5151
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10197207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009954985Medicaid
TN4088303OtherBCBS
AL510-49307OtherBCBS
P00140874OtherRAILROAD MEDICARE
ALP00744568OtherRAILROAD MEDICARE
AL515-21837OtherBCBS
AL112762Medicaid
25-10137OtherUNITED HEALTHCARE
AL112766Medicaid
AL112768Medicaid
4306519OtherAETNA
AL510-49318OtherBCBS
AL510-49462OtherBCBS
MS07776571Medicaid
AL102I064969Medicare PIN
P00140874OtherRAILROAD MEDICARE
4306519OtherAETNA