Provider Demographics
NPI:1982775599
Name:LITTLEFIELD, DAVID T (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:LITTLEFIELD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W 113TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-5208
Mailing Address - Country:US
Mailing Address - Phone:816-305-4444
Mailing Address - Fax:
Practice Address - Street 1:1701 W 133RD ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64145-1631
Practice Address - Country:US
Practice Address - Phone:816-305-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02151152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0001942AMedicare ID - Type Unspecified
KS0001942AMedicare PIN
T42508Medicare UPIN
KST42508Medicare UPIN
KS1982775599Medicare NSC