Individual
NICOLE A SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6300 HOSPITAL PKWY STE 375, JOHNS CREEK, GA 30097-2461
(770) 771-5270
(770) 771-5279
Mailing address
510 VICTORIA PL APT B2, THOMASVILLE, GA 31792-6657
(321) 537-5306
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
82173
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
04/10/2015
Last updated
04/04/2019
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