Little, Mark Brian

Little, Mark Brian is an individual health care provider with primary practice located at 300 W Hospital Road Eisenhower Army Medical Center Attn Credentials, Fort Gordon GA 30905-5650. He recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as his primary health care specialty. Little, Mark Brian can be contacted via phone (706) 787-2720.

Contact Information

Primary practice address
300 W Hospital Road Eisenhower Army Medical Center Attn Credentials Fort Gordon GA 30905-5650
Phone: (706) 787-2720
Fax: (706) 787-8176
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 3420 South Carolina
Speech, Language and Hearing Service Providers / Audiologist 231H00000X AUD003676 Georgia

Profile Details

NPI number 1821000514
LBN Legal business name Little, Mark Brian
Credentials AU D
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2006
Last updated May 8th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821000514 NPPES
South Carolina MEDICAID SA0620

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