Individual
NEIL LESLIE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3020 BONBROOK DR, WFBH FAMILY MEDICINE-REYNOLDA, WINSTON SALEM, NC 27106-3020
(336) 713-5393
Mailing address
3020 BONBROOK DR, WFBH FAMILY MEDICINE-REYNOLDA, WINSTON SALEM, NC 27106-3020
(336) 713-5393
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2012-01633
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
0102203069
VA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
2012-01633
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
2612
WV
Other
Enumeration date
06/04/2009
Last updated
11/12/2018
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