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General NPI Number Information
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NPI Number | 1386946952
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Entity Type | Organization
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Legal Business Name | DENNIS A SPARKS MD INC
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 2831 S HURSTBOURNE PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40220-4112
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Country | US
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Telephone | 502-491-6963
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Fax | 402-491-8398
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Provider Business Mailing Address
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Address Line | 2831 S HURSTBOURNE PKWY
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City | LOUISVILLE
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State | KY
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Zip | 40220-4112
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Country | US
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Telephone | 502-491-6963
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Fax | 402-491-8398
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DENNIS A SPARKS
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Credential | M.D.
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Telephone | 502-491-6963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NULL
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