Individual
GERALD ANTHONY SPARKS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1903 HAND AVE, BAY MINETTE, AL 36507-4112
(251) 937-7970
(251) 937-9260
Mailing address
1903 HAND AVE, BAY MINETTE, AL 36507-4112
(251) 937-7970
(251) 937-9260
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21976
AL
207Q00000X
Family Medicine Physician
Primary
00021976
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009936961
—
AL
05
—
009996010
—
AL
01
—
1770533507
TRICARE SOUTH
AL
01
—
510-03800
BCBS
—
01
—
51510991
BCBS
AL
Enumeration date
05/11/2006
Last updated
02/02/2011
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