Provider Demographics
NPI:1881280352
Name:LITTLE, DAVID E
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:LITTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 ANDERSON ANTIOCH RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:OH
Mailing Address - Zip Code:43143-9733
Mailing Address - Country:US
Mailing Address - Phone:740-869-3858
Mailing Address - Fax:
Practice Address - Street 1:2565 LONDON GROVEPORT RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-9844
Practice Address - Country:US
Practice Address - Phone:614-277-2921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-17
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03117469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist