Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | MD30089 | TN |
NPI | 1346268729 |
---|---|
Provider Name | Dr. John P Little |
First Address | Knoxville, TN 37916-2287 |
Second Address | Knoxville, TN 37916-2287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AETNA | 5721597 (01) | |
BLUECROSS BLUESHIELD | 4032968 (01) | TN |