Healthcare Provider Details

I. General information

NPI: 1134218100
Provider Name (Legal Business Name): JAMES PETER LITTLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 SPRING CREEK RD
CHATTANOOGA TN
37412-3970
US

IV. Provider business mailing address

1011 SPRING CREEK RD
CHATTANOOGA TN
37412-3970
US

V. Phone/Fax

Practice location:
  • Phone: 423-510-0092
  • Fax: 866-723-8928
Mailing address:
  • Phone: 423-510-0092
  • Fax: 866-723-8928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number15701
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number15701
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number15701
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number23638
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: