Provider Demographics
NPI:1447370911
Name:LITTLETON, JOE D
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:D
Last Name:LITTLETON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 493
Mailing Address - Street 2:
Mailing Address - City:WEST PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42086-0493
Mailing Address - Country:US
Mailing Address - Phone:270-443-3917
Mailing Address - Fax:270-415-9881
Practice Address - Street 1:155 STRATHMOOR BLVD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9168
Practice Address - Country:US
Practice Address - Phone:270-443-3917
Practice Address - Fax:270-415-9881
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator