1972597417 NPI number — CARI DAWN STAGGS-LITTRELL R.D., C.D.

Table of content: CARI DAWN STAGGS-LITTRELL R.D., C.D. (NPI 1972597417)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972597417 NPI number — CARI DAWN STAGGS-LITTRELL R.D., C.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STAGGS-LITTRELL
Provider First Name:
CARI
Provider Middle Name:
DAWN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.D., C.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972597417
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DUNN MEMORIAL HOSPITAL
Provider Second Line Business Mailing Address:
1600 23RD STREET
Provider Business Mailing Address City Name:
BEDFORD
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-275-3331
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DUNN MEMORIAL HOSPITAL
Provider Second Line Business Practice Location Address:
1600 23RD STREET
Provider Business Practice Location Address City Name:
BEDFORD
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-275-3331
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133VN1006X , with the licence number:  37001432A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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