Provider Demographics
NPI:1548539133
Name:LITTLE, CARL DOUGLAS JR (DC)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:DOUGLAS
Last Name:LITTLE
Suffix:JR
Gender:M
Credentials:DC
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 211
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-1003
Mailing Address - Country:US
Mailing Address - Phone:706-776-2815
Mailing Address - Fax:706-776-2815
Practice Address - Street 1:386 HIGHWAY 441 BYP
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:GA
Practice Address - Zip Code:30511-1807
Practice Address - Country:US
Practice Address - Phone:706-776-2815
Practice Address - Fax:706-776-2815
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor