Basic Information
Provider Information
NPI: 1225107857
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LITTLEWOOD
FirstName: KEITH
MiddleName: E.
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 9007
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229069007
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1215 LEE ST
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229080001
CountryCode: US
TelephoneNumber: 4349242283
FaxNumber: 4349820019
Other Information
ProviderEnumerationDate: 11/07/2006
LastUpdateDate: 10/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X0101045421VAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home