Individual
MARK J LITTLEHALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
35408
KY
207VX0000X
Obstetrics Physician
Primary
01077457A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108276
BCBS PROVIDER NUMBER
—
05
—
300016537
—
IN
01
—
35408
KENTUCKY MEDICAL LICENSE
KY
05
—
64003163
—
KY
Enumeration date
07/21/2006
Last updated
05/22/2019
Update your record
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