Provider Demographics
NPI:1467427930
Name:SPARKS, MARGARET K (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:K
Last Name:SPARKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19027
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40259-0027
Mailing Address - Country:US
Mailing Address - Phone:866-200-9874
Mailing Address - Fax:502-966-9175
Practice Address - Street 1:381 MEADOWVIEW DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5225
Practice Address - Country:US
Practice Address - Phone:828-263-0067
Practice Address - Fax:828-263-0203
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000627207N00000X
KY23102207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000043325OtherANTHEM OF KY
154905OtherMEDCOST
NC0309404OtherUNITED HEALTHCARE
NC126NKOtherBCBS OF NORTH CAROLINA
521530498OtherNON-PAR COMMERCIAL
126NKOtherBCBS-ITS
KY010024921OtherRAILROAD MEDICARE
KY0309404OtherUNITED HEALTHCARE
B92864Medicare UPIN
KY010024921OtherRAILROAD MEDICARE
NC126NKOtherBCBS OF NORTH CAROLINA
126NKOtherBCBS-ITS
521530498OtherNON-PAR COMMERCIAL