Individual
DR. JOHN ROBERT SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1410 CROWN DRIVE, KIRKSVILLE, MO 63501-0703
(660) 665-1400
(660) 665-2081
Mailing address
PO BOX 703, 1410 CROWN DRIVE, KIRKSVILLE, MO 63501-0703
(660) 665-1400
(660) 665-2081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R5954
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11404039
BLUE CROSS BLUE SHIELD
MO
01
—
273051
HEALTHLINK
MO
Enumeration date
09/15/2006
Last updated
10/03/2007
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