Individual
DR. THOMAS WAYNE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
LSU UNIT, 5825 AIRLINE HIGHWAY, BATON ROUGE, LA 70805
(225) 358-1179
Mailing address
19411 W PINEY POINT AVE, BATON ROUGE, LA 70817-2738
(225) 756-1340
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184403
—
LA
Enumeration date
07/07/2005
Last updated
06/17/2008
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