Provider Demographics
NPI:1912234212
Name:SUNSHINE A LITTLE MD
Entity Type:Organization
Organization Name:SUNSHINE A LITTLE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNSHINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-896-3336
Mailing Address - Street 1:3824 NE EVANGELINE THRUWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-0000
Mailing Address - Country:US
Mailing Address - Phone:337-896-3336
Mailing Address - Fax:337-896-3376
Practice Address - Street 1:3824 NE EVANGELINE THRUWAY
Practice Address - Street 2:SUITE B
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-0000
Practice Address - Country:US
Practice Address - Phone:337-896-3336
Practice Address - Fax:337-896-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA202245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1505731Medicaid
LA1881803138OtherDR'S INDIVIDUAL NPI
LA1505731Medicaid