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General NPI Number Information
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NPI Number | 1326237611
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Entity Type | Organization
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Legal Business Name | KALAMAZOO VALLEY FAMILY PRACTICE PC
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 1821 WHITES RD SUITE C
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City | KALAMAZOO
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State | MI
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Zip | 49008-4805
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Country | US
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Telephone | 269-381-7220
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Fax | 269-381-7224
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Provider Business Mailing Address
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Address Line | 1821 WHITES RD SUITE C
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City | KALAMAZOO
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State | MI
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Zip | 49008-4805
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Country | US
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Telephone | 269-381-7220
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Fax | 269-381-7224
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Authorized Official
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Title or Position | OWNER
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Name | DR. WAYNE FRANCIS LITTLE
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Credential | MD
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Telephone | 269-381-7220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301044950
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License Number State | MI
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