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NPI Code Detail

MEDICARE: RHONDA A SPARKS MD

MEDICARE: RHONDA A 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 Physician01075874AIN
2207Q00000XFamily Medicine Physician19503OK

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 : 1043288822
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHONDA A SPARKS MD
Provider Business Mailing Address
First Line : PO BOX 740020
Second Line :
City : ATLANTA
State : GA
Zip : 30374-0020
Country : US
Telephone Number : 312-733-9730
Fax Number : 773-866-8014
Provider Business Practice Location Address
First Line : 2130 SW 59TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73119-7025
Country : US
Telephone Number : 403-303-7555
Fax Number : 405-561-5615
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 02/04/2022

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Directions to “ RHONDA A SPARKS MD” Practice Location

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