Provider Demographics
NPI:1780695783
Name:SPARLING, WENDY L (DO)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:SPARLING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 COMMERCE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8349
Mailing Address - Country:US
Mailing Address - Phone:614-898-3006
Mailing Address - Fax:614-898-3023
Practice Address - Street 1:101 COMMERCE PARK DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8349
Practice Address - Country:US
Practice Address - Phone:614-898-3006
Practice Address - Fax:614-898-3023
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2073054Medicaid
OHH257200Medicare PIN
OH9132776-005OtherCIGNA
OHG98903Medicare UPIN
OH2073054Medicaid
OH0884457Medicare PIN
OH638760OtherAETNA