Provider Demographics
NPI:1508854456
Name:LITTLE, WAYNE FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:FRANCIS
Last Name:LITTLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1821 WHITES RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-4805
Mailing Address - Country:US
Mailing Address - Phone:269-381-7220
Mailing Address - Fax:269-381-7224
Practice Address - Street 1:1821 WHITES RD
Practice Address - Street 2:SUITE C
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-4805
Practice Address - Country:US
Practice Address - Phone:269-381-7220
Practice Address - Fax:269-381-7224
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2012-10-01
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Provider Licenses
StateLicense IDTaxonomies
MI4301044950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4516768Medicaid
MI4516768Medicaid
MIA77078Medicare UPIN