Little, Kenneth M

Little, Kenneth M is an sole proprietor health care provider with primary practice located at 190 E Bannock St 10Th Floor, Boise ID 83712-6241. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Little, Kenneth M can be contacted via phone (208) 381-5500.

Contact Information

Primary practice address
190 E Bannock St 10Th Floor Boise ID 83712-6241
Phone: (208) 381-5500
Fax: (208) 381-2555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X M8861 Idaho

Profile Details

NPI number 1023039468
LBN Legal business name Little, Kenneth M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 21st, 2006
Last updated Dec 29th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023039468 NPPES
Other 000010152057 REGENCE BLUE SHIELD
Other 269560 REGENCE BLUE SHIELD
Other 8J190 REGENCE BLUE SHIELD
Other 0203233 REGENCE BLUE SHIELD
MEDICAID 860902000 REGENCE BLUE SHIELD
Other 610978600 REGENCE BLUE SHIELD
MEDICAID 807732400 REGENCE BLUE SHIELD
Other 74906 REGENCE BLUE SHIELD

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