Doctor Name: | MARK STEVEN LITTLE |
NPI Number: | 1164827135 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | I.D.C. |
License Number: | |
Business Practice Address: | 3d Marine Division Unit 35801 Fpo, AP - 963825801 |
Business Phone Number: | 9497677948 |
Business Fax Number: | |
Mailing Address: | 3rd Marine Division, OKINAWA |
State: | OKINAWA |
Postal Code: | 9042171 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/03/2014 |
NPI Last Update Date: | 11/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |