Individual
DR. JENNIFER DAWN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
629 MAIN ST, KLAMATH FALLS, OR 97601-6007
(541) 884-8322
(541) 884-7121
Mailing address
2640 BIEHN ST, KLAMATH FALLS, OR 97601-1181
(541) 884-8322
(541) 884-7121
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2975T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004571011
BCBS
OR
05
—
022812
—
OR
01
—
P00208178
RAILROAD MEDICARE
OR
01
—
XSD000850
MEDI-CAL
OR
01
—
XSD000860
MEDI-CAL
OR
Enumeration date
03/24/2006
Last updated
07/17/2012
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