Organization
STEVEN B SPARKS DO LTD LLC
Active
Other names
Steven B Sparks DO
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN B SPARKS DO (OWNER)
(419) 626-5252
Entity
Organization
Contact information
Practice address
1723 COLUMBUS AVE, STE D, SANDUSKY, OH 44870-3546
(419) 626-5252
(419) 626-5335
Mailing address
1723 COLUMBUS AVE, STE D, SANDUSKY, OH 44870-3546
(419) 626-5252
(419) 626-5335
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000258764
ANTHEM BLUE CROSS
OH
Enumeration date
10/03/2005
Last updated
08/27/2007
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