Kenneth M Little
Neurosurgeon
190 E Bannock St 10th Floor
Boise
, Idaho 83712-6241
Kenneth M Little
Neurosurgeon
190 E Bannock St 10th Floor
Boise
, Idaho 83712-6241
(208) 367-2968
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Kenneth M Little
- 190 E Bannock St
- Boise, ID
- Zip : 83712-6241
- Fax : (208) 367-2968
- Phone : (208) 381-2222
Second Address
- Kenneth M Little
- 190 E Bannock St 10th Floor
- Boise, ID
- Zip : 83712-6241
- Fax : (208) 381-2555
- Phone : (208) 381-5500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | M8861 | ID |
National Provider Identifier
| NPI | 1023039468 |
|---|---|
| Provider Name | Kenneth M Little |
| First Address | Boise, ID 83712-6241 |
| Second Address | Boise, ID 83712-6241 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/07/2006 |
| Last Update Date | 29/12/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000010152057 | REGENCE BLUE SHIELD (01) | |
| 0203233 | WA DEPARTMENT OF LABOR (01) | WA |
| 269560 | OMAP (01) | OR |
| 610978600 | US DEPARTMENT OF LABOR (01) | |
| 74906 | BLUE CROSS OF IDAHO (01) | ID |
| 807732400 | (05) | ID |
| 860902000 | (05) | ID |
| 8J190 | BLUE CROSS OF IDAHO GROUP (01) | ID |
| I08776 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.