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Individual

DR. SHANE SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2 SAINT VINCENT CIR, LITTLE ROCK, AR 72205-5423
(501) 686-8000
Mailing address
1725 CENTENNIAL CLUB DR, CONWAY, AR 72034-8194
(501) 690-5134

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
E-6553
AR
2084P0802X
Addiction Psychiatry Physician
E-6553
AR

Other

Enumeration date
09/21/2007
Last updated
12/13/2016
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