MEDICARE: DR. DANNY RAY 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
1	207X00000X	Orthopaedic Surgery Physician	13891	AL

General Provider Information

NPI Number	:	1225082696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANNY RAY SPARKS MD

Provider Business Mailing Address
First Line	:	3102 RAINBOW DR
Second Line	:
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-5804
Country	:	US
Telephone Number	:	256-546-8127
Fax Number	:	256-666-4690

Provider Business Practice Location Address
First Line	:	3102 RAINBOW DR
Second Line	:
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-5804
Country	:	US
Telephone Number	:	256-546-8127
Fax Number	:	256-547-6720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	07/05/2023

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