Provider Demographics
NPI:1508829383
Name:SPARKUHL, ALEXANDER R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:R
Last Name:SPARKUHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SHADOW LN
Mailing Address - Street 2:430
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4126
Mailing Address - Country:US
Mailing Address - Phone:702-384-0500
Mailing Address - Fax:702-384-0093
Practice Address - Street 1:700 SHADOW LN
Practice Address - Street 2:430
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4126
Practice Address - Country:US
Practice Address - Phone:702-384-0500
Practice Address - Fax:702-384-0093
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV4211208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2002958Medicaid
NV2002958Medicaid
NVC96592Medicare UPIN