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General NPI Number Information
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NPI Number | 1033455829
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Entity Type | Individual
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Provider Name | DR. TOM L SPARKS
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Gender | Male
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Dates
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Enumeration Date | 12/24/2012
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Last Update Date | 12/24/2012
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Provider Practice Location Address
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Address Line | 1206 N HIGHWAY 81 STE 42
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City | DUNCAN
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State | OK
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Zip | 73533-1790
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Country | US
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Telephone | 580-251-0107
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E HIGHWAY 7 RD
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City | MARLOW
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State | OK
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Zip | 73055-8641
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Country | US
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Telephone | 580-540-6565
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 7971
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License Number State | OK
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