Provider Demographics
NPI:1205857075
Name:LITTLE, LOREN EVERTON (MD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:EVERTON
Last Name:LITTLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2090 E FLAMINGO RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5116
Mailing Address - Country:US
Mailing Address - Phone:702-733-9271
Mailing Address - Fax:702-733-1556
Practice Address - Street 1:2090 E FLAMINGO RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5116
Practice Address - Country:US
Practice Address - Phone:702-733-9271
Practice Address - Fax:702-733-1556
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-03-18
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Provider Licenses
StateLicense IDTaxonomies
NV2972207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C96275Medicare UPIN
NVVWQBBJ01Medicare ID - Type Unspecified