Provider Demographics
NPI:1821095324
Name:LITTLE, KATHERINE SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:SUE
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3366 NW EXPRESSWAY 580
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4498
Mailing Address - Country:US
Mailing Address - Phone:405-949-2215
Mailing Address - Fax:405-949-1056
Practice Address - Street 1:3366 NW EXPRESSWAY 580
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4498
Practice Address - Country:US
Practice Address - Phone:405-949-2215
Practice Address - Fax:405-949-1056
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15253207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKE20591Medicare UPIN