Provider Demographics
NPI:1902995111
Name:LITTLE, TONYA DEE SMITH (MD)
Entity Type:Individual
Prefix:DR
First Name:TONYA
Middle Name:DEE SMITH
Last Name:LITTLE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3724 RALEIGH ROAD PKWY W
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-9742
Mailing Address - Country:US
Mailing Address - Phone:252-246-8890
Mailing Address - Fax:252-246-8848
Practice Address - Street 1:3724 RALEIGH ROAD PKWY W
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-9742
Practice Address - Country:US
Practice Address - Phone:252-246-8840
Practice Address - Fax:252-246-8841
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2022-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC97-01464207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC97-01464OtherSTATE LICENCE NUMBER
NC8912246Medicaid
G99425Medicare UPIN
NC234498Medicare PIN