Individual
DR. DAVID MICHAEL SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
415 FAIRVIEW AVE, SUITE 201, PONCA CITY, OK 74601-1923
(580) 762-0202
(580) 762-0219
Mailing address
415 FAIRVIEW AVE, SUITE 201, PONCA CITY, OK 74601-1923
(580) 762-0202
(580) 762-0219
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
22621
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200060140B
—
OK
01
—
7222705
AETNA
OK
Enumeration date
05/18/2006
Last updated
09/16/2020
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