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Contact Information

BLAKE ALLEN LITTLE, M.D., L.L.C.
5612 E 117TH PL
TULSA, OK74137
 Phone: 918-510-0129
 Fax: 918-296-5172
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for BLAKE ALLEN LITTLE MD LLC · (Female)

NPI # 1659480713
Status Active
Credentials
Entity Individual
Enumeration date 08/30/2006
Last updated 05/22/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • AR License # N-8113
  • GA License # 58363
  • IL License # 036-106221
  • KS License # 04-25029
  • MN License # 1170
  • MO License # R4J98
  • OK License # 16264
  • TN License # 40672
  • AR Medicaid 121409001
  • KS Medicaid 2050549604
  • MO Medicaid 206894506
  • OK Medicaid A4877801498
  • AR Other 55425 ARKANSAS BLUE CROSS
  • KS Other 0000205533 KS BLUE CROSS
  • MO Other 150325 MO BLUE CROSS
  • MO Other 7404 MO BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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