Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 35-062352 | OH |
NPI | 1013915610 |
---|---|
Provider Name | Dr. Robert A. Little |
First Address | Miamisburg, OH 45342-3794 |
Second Address | Centerville, OH 45459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 18/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0858371 | (05) | OH |
F92510 | (02) | OH |