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Individual

TONY SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(770) 732-3800
Mailing address
5665 NEW NORTHSIDE DR NW, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-5400

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN107315
GA
363LF0000X
Family Nurse Practitioner
RN107315
GA
363LX0106X
Occupational Health Nurse Practitioner
RN107315
GA

Other

Enumeration date
06/18/2009
Last updated
05/15/2021
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