# SPARROW MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194980524
- **Authorized official:** MILDRED WARE SCOTT PHD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (318) 934-0082

## Contact information

- **Practice address:** 3736 N MARKET ST, SHREVEPORT, LA 71107-3104
- **Practice address phone:** (318) 934-0082
- **Practice address fax:** (318) 934-0087
- **Mailing address:** PO BOX 7276, SHREVEPORT, LA 71137-7276
- **Mailing address phone:** (318) 934-0082
- **Mailing address fax:** (318) 934-0087

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2008
- **Last updated:** 08/20/2008