Individual
DR. KENDRICK LADEL SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
(601) 249-1714
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 649-2863
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
24476
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02589533
—
MS
Enumeration date
04/04/2007
Last updated
05/09/2024
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