Healthcare Provider Details

I. General information

NPI: 1235285511
Provider Name (Legal Business Name): MARCIA J. LITTLES, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 03/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD SUITE D100
MOBILE AL
36608-6705
US

IV. Provider business mailing address

PO BOX 851387
MOBILE AL
36685-1387
US

V. Phone/Fax

Practice location:
  • Phone: 251-633-6332
  • Fax: 251-633-3660
Mailing address:
  • Phone: 251-366-3662
  • Fax: 251-633-3660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number12672
License Number StateAL

VIII. Authorized Official

Name: MARCIA J LITTLES
Title or Position: CEO
Credential: M.D.
Phone: 251-633-3662