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Individual

DR. ISAAC SAMUEL SPARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
301 E WENDOVER AVE STE 215, GREENSBORO, NC 27401-1207
(336) 379-1156
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2024-01122
NC
207Q00000X
Family Medicine Physician
9695910-1204
UT

Other

Enumeration date
06/26/2013
Last updated
06/19/2024
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