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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, M.D., L.L.C.

NPI # 1659480713
LBN Legal business name BLAKE ALLEN LITTLE, M.D., L.L.C.
Authorized official MELISSA QUALLS - (MGMR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/30/2006
Last updated 05/22/2018 - About 8 years ago
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
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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