Individual
BRIAN LITLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 N OAK ST, O FALLON, IL 62269-1165
(618) 624-3368
Mailing address
103 N OAK ST, O FALLON, IL 62269-1165
(618) 624-3368
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036115897
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-115897
LICENSE NUMBER
IL
01
—
P00423745
RAILROAD MEDICARE
—
Enumeration date
09/27/2006
Last updated
01/20/2022
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