Provider Demographics
NPI:1972642981
Name:SPARKS, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SPARKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1 GENERAL ST
Mailing Address - Street 2:LAMPREY BUILDING, 4TH FLOOR
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-2961
Mailing Address - Country:US
Mailing Address - Phone:978-983-0488
Mailing Address - Fax:978-794-0458
Practice Address - Street 1:1 GENERAL ST
Practice Address - Street 2:LAMPREY BUILDING, 4TH FLOOR
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2961
Practice Address - Country:US
Practice Address - Phone:978-983-0488
Practice Address - Fax:978-794-0458
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-03-07
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Provider Licenses
StateLicense IDTaxonomies
MA235495207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine