Healthcare Provider Details

I. General information

NPI: 1497007009
Provider Name (Legal Business Name): SARAH CREWS SPARKS LOCHREN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 BIENVILLE BLVD STE 220
OCEAN SPRINGS MS
39564-5705
US

IV. Provider business mailing address

3535 BIENVILLE BLVD STE 220
OCEAN SPRINGS MS
39564-5705
US

V. Phone/Fax

Practice location:
  • Phone: 228-872-1641
  • Fax: 228-818-4178
Mailing address:
  • Phone: 228-872-1641
  • Fax: 228-818-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA00394
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: