Provider Demographics
NPI:1801806047
Name:LITTMANN, PHILLIP EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:EDWARD
Last Name:LITTMANN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-0188
Mailing Address - Country:US
Mailing Address - Phone:740-773-4366
Mailing Address - Fax:740-775-7855
Practice Address - Street 1:2541 PANTHER DR NE
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-9081
Practice Address - Country:US
Practice Address - Phone:740-342-4192
Practice Address - Fax:740-342-4045
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-3668-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0867683Medicaid
ORLI 0622355Medicare ID - Type Unspecified
OH0867683Medicaid