Provider Demographics
NPI:1760460208
Name:LITTLE, WALTER F III (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:F
Last Name:LITTLE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2801 CHARLOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4035
Mailing Address - Country:US
Mailing Address - Phone:615-250-9200
Mailing Address - Fax:615-250-9251
Practice Address - Street 1:585 E BLEDSOE ST
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3037
Practice Address - Country:US
Practice Address - Phone:615-452-5225
Practice Address - Fax:615-230-8907
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD23723208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0151629OtherBLUE CROSS
TN340013323OtherRR MEDICARE
TN3069037Medicaid
KY64928088Medicaid
C68867Medicare UPIN