Little, Blake A
Little, Blake A is an individual health care provider with primary practice located at 1120 S Utica Ave , Tulsa OK 74104-4012. He recently has only one registered license in Allopathic & Osteopathic Physicians / Critical Care Medicine, which is considered as his primary health care specialty. Little, Blake A can be contacted via phone (918) 579-1000.Contact Information
Primary practice address
1120 S Utica Ave
Tulsa OK 74104-4012
Phone: (918) 579-1000
Fax: (918) 579-1218
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 16264 | Oklahoma |
Profile Details
| NPI number | 1386688778 |
|---|---|
| LBN Legal business name | Little, Blake A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Jan 30th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386688778 | NPPES |
| Missouri | MEDICAID | 206894506 | |
| Missouri | Other | 0000205533 | |
| Missouri | MEDICAID | 100156240H | |
| Missouri | MEDICAID | 121409001 | |
| Missouri | Other | 55425 | |
| Missouri | MEDICAID | 100178780A | |
| Missouri | MEDICAID | 2050549604 |
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