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Organization

SH MEDICAL GROUP

Active
Other names
Acorn to Oak Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
STACEY DES MARAIS SPARKS M.D. (CO OWNER)
(318) 949-0539
Entity
Organization

Contact information

Practice address
1025 HIGHWAY 80, HAUGHTON, LA 71037-7425
(318) 949-0539
(318) 949-0759
Mailing address
1025 HIGHWAY 80, HAUGHTON, LA 71037-7425
(318) 949-0539
(318) 949-0759

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD.205277
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1515728
LA
01
MD.205277
PROFESSIONAL LICENSE
LA
Enumeration date
10/20/2016
Last updated
10/20/2016
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