Individual
KEITH BRIAN SPARKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1013 SPRING CREEK RD, CHATTANOOGA, TN 37412
(423) 855-8288
(423) 855-4527
Mailing address
1013 SPRING CREEK RD, CHATTANOOGA, TN 37412
(423) 855-8288
(423) 855-4527
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT1603
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2240306
UNITED HEALTH
—
01
—
3088639
BLUE CROSS BLUE SHIELD
—
05
—
3599732
—
TN
01
—
410040394
MEDICARE RAILROAD
—
Enumeration date
12/18/2006
Last updated
04/28/2008
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