Marty Robert Litchfield, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0000001836 Issued in TN

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 461-0309

NPI assigned

Nov 18, 2005

Last updated

Apr 10, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Kentucky Dermatology, PSC

  • Dermatology Physician
  • Madisonville, KY
  • NPI 1275580888

  Physician Assistant

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1306828900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4071 SINGLETREE DR",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422409191",
            "telephone_number": "270-707-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-461-0309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 North Main St",
            "address_2": "West Kentucky Dermatology",
            "address_purpose": "LOCATION",
            "city": "Madisonville",
            "state": "KY",
            "postal_code": "42431",
            "country_code": "US",
            "telephone_number": "270-821-0066",
            "fax_number": "270-821-1296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITCHFIELD",
        "first_name": "MARTY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000001836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lilley, DPT
• Carol Lindsey, CNM
• James Earl Link III
• Michael W Lipe, LCSW
• Ryan Lipe
• Amy Cao Liu, MD
• Yolanda Livingston, APRN
• Joshua Ian Lockwood, RDN
• Bret W. Logan, M.D, PLC
• Deborah Anne Logan, CRDH

• Physician Assistant in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.