Healthcare Provider Details

I. General information

NPI: 1144291550
Provider Name (Legal Business Name): MICHAEL EDWARD LITTLE JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 AIRPORT BLVD
MOBILE AL
36608-2207
US

IV. Provider business mailing address

3920 AIRPORT BLVD
MOBILE AL
36608-2207
US

V. Phone/Fax

Practice location:
  • Phone: 251-342-4723
  • Fax: 251-344-6752
Mailing address:
  • Phone: 251-342-4723
  • Fax: 251-344-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200000878
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: