Provider Demographics
NPI:1366627838
Name:WENDY L. SPARLING, D.O. INC.
Entity Type:Organization
Organization Name:WENDY L. SPARLING, D.O. INC.
Other - Org Name:SUNBURY SQUARE FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPARLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:740-965-3076
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-0449
Mailing Address - Country:US
Mailing Address - Phone:740-965-6579
Mailing Address - Fax:740-965-8135
Practice Address - Street 1:27 N VERNON ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-9374
Practice Address - Country:US
Practice Address - Phone:740-965-3076
Practice Address - Fax:740-965-8135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-005972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2073054Medicaid
638760OtherAETNA
0104201OtherUNITED HEALTH CARE
9132776-005OtherCIGNA
OH000000162940OtherANTHEM BC/BS
=========OtherNATIONWIDE
OH2073054Medicaid