Provider Demographics
NPI:1578761276
Name:SPARROW, THOMAS G (STATE LICENSED HEARI)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:G
Last Name:SPARROW
Suffix:
Gender:M
Credentials:STATE LICENSED HEARI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-3101
Mailing Address - Country:US
Mailing Address - Phone:314-481-3700
Mailing Address - Fax:314-487-6713
Practice Address - Street 1:5208 HAMPTON AVE
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63109-3101
Practice Address - Country:US
Practice Address - Phone:314-481-3700
Practice Address - Fax:314-487-6713
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO528237700000X
IL0881237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist