Individual
CAROLYN DENISE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2615 EAST FRANKLIN AVENUE, UFP SMILEY'S CLINIC, MINNEAPOLIS, MN 55406
(612) 333-0770
(612) 359-0475
Mailing address
420 DELAWARE STREET SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 333-0770
(612) 359-0475
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45486
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-14574
MEDICA CHOICE
MN
01
—
1034262
PREFERRED ONE
MN
01
—
171764
UCARE
MN
01
—
1906624
ARAZ
MN
01
—
HP38751
HEALTH PARTNERS
MN
Enumeration date
10/18/2006
Last updated
07/08/2007
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