MEDICARE: DAVID W LITTLE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD00029900	WA

General Provider Information

NPI Number	:	1396743043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID W LITTLE MD

Provider Business Mailing Address
First Line	:	PO BOX 421
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-0421
Country	:	US
Telephone Number	:	509-944-9440
Fax Number	:	509-227-7070

Provider Business Practice Location Address
First Line	:	16528 E DESMET CT
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99216-3522
Country	:	US
Telephone Number	:	509-944-9440
Fax Number	:	509-227-7070

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	05/24/2021

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