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NPI Code Detail

MEDICARE: DR. DAVID PARKER SPARKS MD

MEDICARE: DR. DAVID PARKER SPARKS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD19242TN
2207Q00000XFamily Medicine Physician201101511NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033116488
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID PARKER SPARKS MD
Provider Business Mailing Address
First Line : 1105 FAIRGROVE CHURCH RD SE
Second Line :
City : CONOVER
State : NC
Zip : 28613-9090
Country : US
Telephone Number : 828-267-0551
Fax Number : 828-267-0531
Provider Business Practice Location Address
First Line : 1105 FAIRGROVE CHURCH RD SE
Second Line :
City : CONOVER
State : NC
Zip : 28613-9090
Country : US
Telephone Number : 828-267-0551
Fax Number : 828-267-0531
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 11/11/2013

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