Individual
DR. PATRICIA LYNN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
I3-0001254
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264546ZE5F
MEDICARE PTAN
DE
Enumeration date
09/23/2006
Last updated
07/11/2014
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