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Organization

ROBERT W. SPARKS, D.O, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT W SPARKS D.O. (PHYSICIAN/OWNER)
(660) 627-1560
Entity
Organization

Contact information

Practice address
2200 S HALLIBURTON ST, KIRKSVILLE, MO 63501-4651
(660) 627-1560
(660) 665-0533
Mailing address
2200 S HALLIBURTON ST, KIRKSVILLE, MO 63501-4651
(660) 627-1560
(660) 665-0533

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R9D41
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
505674903
MO
Enumeration date
10/26/2007
Last updated
08/16/2010
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