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NPI Code Detail

MEDICARE: JERRY MARSHALL LITTLEFIELD DO

MEDICARE: JERRY MARSHALL LITTLEFIELD 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
1207RN0300XNephrology Physician058624GA

General Provider Information

NPI Number : 1417946419
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY MARSHALL LITTLEFIELD DO
Provider Business Mailing Address
First Line : 1825 MARTHA BERRY BLVD NW
Second Line :
City : ROME
State : GA
Zip : 30165-1625
Country : US
Telephone Number : 706-295-5331
Fax Number :
Provider Business Practice Location Address
First Line : 550 REDMOND RD NW
Second Line :
City : ROME
State : GA
Zip : 30165-1416
Country : US
Telephone Number : 706-233-8504
Fax Number : 706-233-8505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 07/09/2007

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Directions to “ JERRY MARSHALL LITTLEFIELD DO” Practice Location

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