Provider Demographics
NPI:1821184136
Name:LITTLE, NELSON K (MD)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:K
Last Name:LITTLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:499 GLOSTER CREEK VLG STE A2
Mailing Address - Street 2:CARDIOLOGY ASSOCIATES OF NORTH MS PA
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-4749
Mailing Address - Country:US
Mailing Address - Phone:662-620-6800
Mailing Address - Fax:662-620-6920
Practice Address - Street 1:499 GLOSTER CREEK VLG STE A2
Practice Address - Street 2:CARDIOLOGY ASSOCIATES OF NORTH MS PA
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-4749
Practice Address - Country:US
Practice Address - Phone:662-620-6800
Practice Address - Fax:662-620-6920
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2019-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS10294207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00016690Medicaid
MS060000708Medicare ID - Type Unspecified
MS00016690Medicaid