MEDICARE: DR. RENE' P. SPARROW DOM

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	171100000X	Acupuncturist	DOM007	AR

General Provider Information

NPI Number	:	1558315945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENE' P. SPARROW DOM

Provider Business Mailing Address
First Line	:	115 E C AVE
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-8805
Country	:	US
Telephone Number	:	501-812-4500
Fax Number	:	501-812-4957

Provider Business Practice Location Address
First Line	:	115 E C AVE
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72116-8805
Country	:	US
Telephone Number	:	501-812-4500
Fax Number	:	501-812-4957

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	07/08/2007

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