Individual
DAVID T SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
800 S ASH ST, NEVADA, MO 64772-3223
(417) 667-3355
(816) 461-6586
Mailing address
800 S ASH ST, NEVADA, MO 64772-3224
(417) 882-6744
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
096000
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918596701
—
MO
Enumeration date
03/21/2006
Last updated
11/21/2017
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