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SPARKS MEDICAL FOUNDATION

Behavioral Health & Social Service Providers Psychologist

Provider NPI: 1386634285

Organization Information:
Organization Name:  SPARKS MEDICAL FOUNDATION
Organization is not Subpart
Authorized Official:  REBECCA  FRIDDLE  SPARKS PROVIDER RELATIONS MANAGER  479-709-7057

Practice Location:
1500 DODSON AVE  FORT SMITH, AR 72901-5182 US
Tel: 479-709-7399  Fax: 479-709-7053

Business Mailing Address:
PO BOX 2420  FORT SMITH, AR 72902-2420 US
Tel: 479-709-7399  Fax: 479-709-7053

NPI Information:
NPI: 1386634285
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103T00000XBehavioral Health & Social Service Providers
Psychologist
N207N00000XPhysicians
Dermatology
Y207Q00000XPhysicians
Family Medicine
N207R00000XPhysicians
Internal Medicine
N207V00000XPhysicians
Obstetrics & Gynecology
N208000000XPhysicians
Pediatrics
N2083X0100XPhysicians
Preventive Medicine
N2084N0400XPhysicians
Psychiatry & Neurology
N2085B0100XPhysicians
Radiology
N2085N0700XPhysicians
Radiology
N2085N0904XPhysicians
Radiology
N2085P0229XPhysicians
Radiology
N208600000XPhysicians
Surgery
N208VP0000XPhysicians
Pain Medicine
N291U00000XLaboratories
Clinical Medical Laboratory

Other Provider Identifiers:

IssuerNumberStateType
100706990JOK05
155188002AR05



American Medical Association 2012 taxonomy code information

Code: 207Q00000X

Type:

Classification:



Definition:



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