Provider Demographics
NPI:1215988282
Name:RUNDELL-LITTLE, JASON WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:WAYNE
Last Name:RUNDELL-LITTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JASON
Other - Middle Name:WAYNE
Other - Last Name:RUNDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2216 N. WILLIAMSGATE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67228-8064
Mailing Address - Country:US
Mailing Address - Phone:316-207-7220
Mailing Address - Fax:
Practice Address - Street 1:1124 W 21ST ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-5500
Practice Address - Country:US
Practice Address - Phone:316-300-4911
Practice Address - Fax:316-300-4940
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME04-30969207P00000X
KS04-30969207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine