Provider Demographics
NPI:1093156374
Name:LITTLE, LEIGHA DAVIS (OD)
Entity Type:Individual
Prefix:
First Name:LEIGHA
Middle Name:DAVIS
Last Name:LITTLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:LEIGHA
Other - Middle Name:S
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2149 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6136
Mailing Address - Country:US
Mailing Address - Phone:928-726-1100
Mailing Address - Fax:
Practice Address - Street 1:2149 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6136
Practice Address - Country:US
Practice Address - Phone:928-726-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1916152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist