Organization
SPARKS CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TWANA LIVETTE SPARKS MD (PRESIDENT)
(505) 538-0486
Entity
Organization
Contact information
Practice address
1000 N. HUDSON ST., SILVER CITY, NM 88061
(505) 538-0486
(505) 538-9179
Mailing address
1000 N. HUDSON ST., SILVER CITY, NM 88061
(505) 538-0486
(505) 538-9179
Taxonomy
Speciality
Code
Description
License number
State
207YX0602X
Otolaryngic Allergy Physician
Primary
87-386NM
NM
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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