Provider Demographics
NPI:1194756809
Name:LITTLE, DWIGHT DOWNS (MD)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:DOWNS
Last Name:LITTLE
Suffix:
Gender:M
Credentials:MD
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 379
Mailing Address - Street 2:
Mailing Address - City:LOTTSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22511-0379
Mailing Address - Country:US
Mailing Address - Phone:804-529-7662
Mailing Address - Fax:
Practice Address - Street 1:250 SUNRISE COURT
Practice Address - Street 2:
Practice Address - City:LOTTSBURG
Practice Address - State:VA
Practice Address - Zip Code:22511
Practice Address - Country:US
Practice Address - Phone:804-529-7662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101029327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5644119Medicaid
C36566Medicare UPIN
VA5644119Medicaid