Provider Demographics
NPI:1700674223
Name:LITTLE, THOMAS RONALD
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:RONALD
Last Name:LITTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RON
Other - Middle Name:THOMAS
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-0111
Mailing Address - Country:US
Mailing Address - Phone:937-931-3469
Mailing Address - Fax:
Practice Address - Street 1:5746 FLINTLOCK LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2654
Practice Address - Country:US
Practice Address - Phone:937-931-3469
Practice Address - Fax:937-931-3469
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant