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1467444075

NPI Code Detail

MEDICARE: MR. WILLIAM LUVERNE LITTLE JR. DO

MEDICARE: MR. WILLIAM LUVERNE LITTLE JR. DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	0102050102	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
10	050068527	OTHER	VA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2000373	OTHER		VIRGINIA PHYSICIAN NETWOR
2	265202	OTHER	VA	ANTHEM
3	54-1951442	OTHER		VIRGINIA HEALTH NETWORK
4	150684200	OTHER		OWCP FED WC VIA ACS
5	54-1951442	OTHER		AETNA
6	54-1951442	OTHER		FOCUS WORKERS COMP
7	54-1951442	OTHER		MIDATLANTIC HEALTH SOLUTI
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	A1797	OTHER		MEDCOST
11	10010979	OTHER	VA	SENTARA PPO
12	54-1951442	OTHER		CORVEL WC PROVIDER NETWOR
13	54-1951442	OTHER		BENESIGHT
14	54-1951442	OTHER		PHCS
15	5714931	OTHER	VA	PREMIER HEALTH PLAN
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
17	2890302001	OTHER		CIGNA
18	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467444075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM LUVERNE LITTLE JR. DO

Provider Business Mailing Address
First Line	:	1558 CHERRY GROVE RD N
Second Line	:
City	:	SUFFOLK
State	:	VA
Zip	:	23432-1822
Country	:	US
Telephone Number	:	757-255-2488
Fax Number	:

Provider Business Practice Location Address
First Line	:	3315 HIGH ST
Second Line	:	THE CENTER FOR PAIN MANAGEMENT
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-3319
Country	:	US
Telephone Number	:	757-399-0759
Fax Number	:	757-397-8951

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	03/18/2010

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1962682534 — MRS. KATIE JANE GERARGE PA-C
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Directions to “ MR. WILLIAM LUVERNE LITTLE JR. DO” Practice Location

Language	Start Address	Practice Location

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