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General NPI Number Information
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NPI Number | 1639351174
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Entity Type | Organization
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Legal Business Name | JERALD J. LITTLEFIELD, MD, PC
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 428 S WASHINGTON ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3630
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Country | US
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Telephone | 703-837-1800
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Fax | 703-837-0951
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Provider Business Mailing Address
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Address Line | 428 S WASHINGTON ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3630
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Country | US
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Telephone | 703-837-1800
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Fax | 703-837-0951
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ELIZABETH T HARRINGTON
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Credential |
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Telephone | 703-837-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101026463
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License Number State | VA
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