Individual
DR. LISA ANN SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20045 N. 19TH AVENUE, BLDG 10, SUITE 3, PHOENIX, AZ 85027-3207
(480) 626-2552
(480) 626-2551
Mailing address
9500 E IRONWOOD SQUARE DR STE 125, SCOTTSDALE, AZ 85258-4582
(480) 626-2552
(480) 626-2551
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13545
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235326
—
AZ
Enumeration date
12/19/2006
Last updated
10/21/2020
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