Organization
G T LITTLE MD P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GENERAL THEOPHILUS LITTLE M.D. (PRESIDENT)
(843) 722-6336
Entity
Organization
Contact information
Practice address
280 RUTLEDGE AVE, CHARLESTON, SC 29403-5352
(843) 722-6336
(843) 722-6302
Mailing address
280 RUTLEDGE AVE, CHARLESTON, SC 29403-5352
(843) 722-6336
(843) 722-6302
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
8051
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
089511
—
SC
Enumeration date
04/05/2010
Last updated
04/05/2010
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