NPI | 1659480713 |
---|---|
Doing Business As | BLAKE ALLEN LITTLE, M.D. |
Entity Type | Organization |
Authorized Contact | MELISSA K QUALLS Mgmr 918-510-0129 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: MO R4J98) |
Additional Taxonomies | 174400000X Specialist (Licence: TN 40672) |
174400000X Specialist (Licence: GA 58363) | |
174400000X Specialist (Licence: AR N-8113) | |
174400000X Specialist (Licence: IL 036-106221) | |
174400000X Specialist (Licence: KS 04-25029) | |
174400000X Specialist (Licence: MN 1170) | |
174400000X Specialist (Licence: OK 16264) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2018-05-22 |