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NPI Code Detail

MEDICARE: G ROGER SPARHAWK JR. MD

MEDICARE:   G ROGER SPARHAWK JR. 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
12084P0800XPsychiatry Physician35.040986OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
20754597OTHEROHMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3341790929185OTHEROHCARESOURCE ID

General Provider Information

NPI Number : 1639158561
Entity Type Code : Individual
Provider Name (Legal Business Name) : G ROGER SPARHAWK JR. MD
Provider Business Mailing Address
First Line : 4125 MEDINA RD
Second Line : SUITE 220
City : AKRON
State : OH
Zip : 44333-2483
Country : US
Telephone Number : 330-665-8225
Fax Number : 330-665-8229
Provider Business Practice Location Address
First Line : 4125 MEDINA RD
Second Line : SUITE 220
City : AKRON
State : OH
Zip : 44333-2483
Country : US
Telephone Number : 330-665-8225
Fax Number : 330-665-8229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2006
Last Update Date : 01/05/2015

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Directions to “ G ROGER SPARHAWK JR. MD” Practice Location

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