Individual
DR. MARK BRIAN LITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU D
Contact information
Practice address
300 W HOSPITAL ROAD, EISENHOWER ARMY MEDICAL CENTER ATTN CREDENTIALS, FORT GORDON, GA 30905-5650
(706) 787-2720
(706) 787-8176
Mailing address
300 W HOSPITAL ROAD, EISENHOWER ARMY MEDICAL CENTER ATTN CREDENTIALS, FORT GORDON, GA 30905-5650
(706) 787-2720
(706) 787-8176
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
3420
SC
231H00000X
Audiologist
Primary
AUD003676
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0620
—
SC
Enumeration date
08/12/2006
Last updated
05/08/2008
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