Healthcare Provider Details

I. General information

NPI: 1205870102
Provider Name (Legal Business Name): GREGORY S LITTLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/02/2025
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 HIGH ST
WILLIAMSPORT PA
17701-3100
US

IV. Provider business mailing address

1201 GRAMPIAN BLVD
WILLIAMSPORT PA
17701-1900
US

V. Phone/Fax

Practice location:
  • Phone: 570-321-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD422568
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD422568
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: