Individual
KENNETH E SPARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 342-7500
Mailing address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 342-7500
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35645
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13893
DEAN HEALTH PLAN
—
01
—
16800226
MEDICARE PART B
—
01
—
2013057
PHYSICIANS PLUS
—
05
—
34110500
—
WI
01
—
35645-20
WI STATE LIC
WI
01
—
390808509
CIGNA
—
01
—
390808509DN
UNITY
—
Enumeration date
10/03/2006
Last updated
03/02/2012
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