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Individual
TONY SPARKS
Active
Individual
TONY SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN107315
GA
363LF0000X
Family Nurse Practitioner
RN107315
GA
363LX0106X
Occupational Health Nurse Practitioner
RN107315
GA
Other
Enumeration date
06/18/2009
Last updated
05/15/2021
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