Healthcare Provider Details

I. General information

NPI: 1700674223
Provider Name (Legal Business Name): THOMAS RONALD LITTLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RON THOMAS LITTLE

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5746 FLINTLOCK LN
COLUMBUS OH
43213-2654
US

IV. Provider business mailing address

PO BOX 111
BLACKLICK OH
43004-0111
US

V. Phone/Fax

Practice location:
  • Phone: 937-931-3469
  • Fax: 937-931-3469
Mailing address:
  • Phone: 937-931-3469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: