Provider Demographics
NPI:1225310972
Name:SPARKS, JENNIFER RACHEL (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:RACHEL
Last Name:SPARKS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:RACHEL
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1111
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-0907
Mailing Address - Country:US
Mailing Address - Phone:215-453-4995
Mailing Address - Fax:215-453-4646
Practice Address - Street 1:99 NORTH WEST END BOULEVARD
Practice Address - Street 2:SUITE 104
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1272
Practice Address - Country:US
Practice Address - Phone:215-536-3200
Practice Address - Fax:215-536-3259
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS017571207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology