Organization
DALLAS FAMILY PRACTICE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G SPARTI D.O. (PRESIDENT/PHYSICIAN)
(770) 445-1095
Entity
Organization
Contact information
Practice address
318 MAIN ST, STE B, DALLAS, GA 30132-4266
(770) 445-1095
(770) 445-5361
Mailing address
PO BOX 89, DALLAS, GA 30132-0002
(770) 445-1095
(770) 445-5361
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16148
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00063764A
—
GA
Enumeration date
06/12/2005
Last updated
12/08/2010
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