| Robert W. Sparks, D.o, P.c. | |
|
2200 S Halliburton St Kirksville MO 63501-4651 | |
| (660) 627-1560 | |
| (660) 665-0533 |
| Full Name | Robert W. Sparks, D.o, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2200 S Halliburton St, Kirksville, Missouri |
| Authorized Official Name and Position | Robert W Sparks (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6606271560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert W. Sparks, D.o, P.c. 2200 S Halliburton St Kirksville MO 63501-4651 Ph: (660) 627-1560 | Robert W. Sparks, D.o, P.c. 2200 S Halliburton St Kirksville MO 63501-4651 Ph: (660) 627-1560 |
| NPI Number | 1992984967 |
|---|---|
| Provider Enumeration Date | 10/26/2007 |
| Last Update Date | 08/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992984967 | NPI | - | NPPES |
| 505674903 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R9D41 (Missouri) | Primary |
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