Individual
JEFFREY O SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 HUFFMAN MILL ROAD, BURLINGTON, NC 27215-8700
(336) 538-1234
(336) 584-6811
Mailing address
1234 HUFFMAN MILL ROAD, BURLINGTON, NC 27215-8700
(336) 538-1234
(336) 584-6811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34228
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1382U
BCBS
NC
05
—
8978567
—
NC
Enumeration date
03/28/2006
Last updated
09/28/2023
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