1336148212 NPI number — THOMAS A LITTLE MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336148212 NPI number — THOMAS A LITTLE MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

LITTLE

Provider First Name:

THOMAS

Provider Middle Name:

A

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1336148212

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

05/10/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

371 E WATER ST STE 2

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

GETTYSBURG

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

17325-1528

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

717-549-2331

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

371 E. WATER ST

Provider Second Line Business Practice Location Address:

STE #2

Provider Business Practice Location Address City Name:

GETTYSBURG

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

17325-1732

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

717-339-9029

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/21/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207X00000X , with the licence number:  MD066808L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 211082 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1523790 . This is a "GATEWAY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 20064229 . This is a "AMERIHEALTH MERCY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 50070340 . This is a "CAPITAL BLUE CROSS-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 7131929 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1302106 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2167387 . This is a "MAMSI-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 610584 . This is a "CAREFIRST MD BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 41062 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 001856908 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 212667 . This is a "UNISON-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".