# SPARKS MEDICAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diagnostic Center at Sparks Medical Plaza-Xray
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962450007
- **Authorized official:** REBECCA COX (CBO SUPPORT MANAGER)
- **Authorized official phone:** (479) 709-7057

## Contact information

- **Practice address:** 1500 DODSON AVE, FORT SMITH, AR 72901-5182
- **Practice address phone:** (479) 709-7404
- **Practice address fax:** (479) 709-7418
- **Mailing address:** PO BOX 2420, FORT SMITH, AR 72902-2420
- **Mailing address phone:** (479) 709-7399
- **Mailing address fax:** (479) 709-7057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | Yes |
| 2085B0100X | Body Imaging Physician | — | — | Yes |
| 2085N0700X | Neuroradiology Physician | — | NULL | — |
| 2085N0700X | Neuroradiology Physician | — | — | — |
| 2085N0904X | Nuclear Radiology Physician | — | NULL | — |
| 2085N0904X | Nuclear Radiology Physician | — | — | — |
| 2085P0229X | Pediatric Radiology Physician | — | NULL | — |
| 2085P0229X | Pediatric Radiology Physician | — | — | — |
| 2085R0001X | Radiation Oncology Physician | — | NULL | — |
| 2085R0001X | Radiation Oncology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0203X | Therapeutic Radiology Physician | — | NULL | — |
| 2085R0203X | Therapeutic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2085R0205X | Radiological Physics Physician | — | NULL | — |
| 2085R0205X | Radiological Physics Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 11/01/2007