Individual
KENNETH M LITTLE
Active
Individual
KENNETH M LITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
M8861
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010152057
REGENCE BLUE SHIELD
—
01
—
0203233
WA DEPARTMENT OF LABOR
WA
01
—
269560
OMAP
OR
01
—
610978600
US DEPARTMENT OF LABOR
—
01
—
74906
BLUE CROSS OF IDAHO
ID
05
—
807732400
—
ID
05
—
860902000
—
ID
01
—
8J190
BLUE CROSS OF IDAHO GROUP
ID
Enumeration date
07/21/2006
Last updated
12/29/2012
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