Provider Demographics
NPI:1427128925
Name:SUSAN LITTLE JONES MD PC
Entity type:Organization
Organization Name:SUSAN LITTLE JONES MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUNKELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-844-9742
Mailing Address - Street 1:75 BARCLAY CIR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5820
Mailing Address - Country:US
Mailing Address - Phone:248-844-0315
Mailing Address - Fax:248-844-0320
Practice Address - Street 1:75 BARCLAY CIR
Practice Address - Street 2:SUITE 120
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5820
Practice Address - Country:US
Practice Address - Phone:248-844-0315
Practice Address - Fax:248-844-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISL073954207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H94463Medicare UPIN
MI0P22300001Medicare ID - Type Unspecified