Individual
DR. MARY L SPARKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5 EXECUTIVE CIR, SAVANNAH, GA 31406-3345
(912) 355-2400
(912) 355-5324
Mailing address
5 EXECUTIVE CIR, SAVANNAH, GA 31406-3345
(912) 355-2400
(912) 355-5324
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
038102
GA
207P00000X
Emergency Medicine Physician
27316
SC
207Q00000X
Family Medicine Physician
038102
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000591313
—
GA
05
—
000591313B
—
GA
05
—
000591313C
—
GA
05
—
000591313D
—
GA
05
—
000591313F
—
GA
05
—
000591313K
—
GA
05
—
000591313L
—
SC
05
—
000591313M
—
GA
01
—
10058953
AMERIGROUP
GA
05
—
F284498055
—
SC
05
—
G38102
—
SC
Enumeration date
06/11/2006
Last updated
08/07/2023
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