MEDICARE: HALEY RUTH SPARKS OD

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	152W00000X	Optometrist	3094	OK

General Provider Information

NPI Number	:	1861006918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY RUTH SPARKS OD

Provider Business Mailing Address
First Line	:	8812 N COUNCIL RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3246
Country	:	US
Telephone Number	:	405-773-3937
Fax Number	:

Provider Business Practice Location Address
First Line	:	8812 N COUNCIL RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3246
Country	:	US
Telephone Number	:	405-773-3937
Fax Number	:

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

Provider Enumeration Date	:	09/06/2020
Last Update Date	:	05/19/2025

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Directions to “ HALEY RUTH SPARKS OD” Practice Location

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