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Contact Information

BEAU SPARKMAN D.D.S., P.A.
104 W RAY FINE BLVD
SUITE 5
ROLAND, OK74954-5289
 Phone: 918-503-6262
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BEAU SPARKMAN D.D.S., P.A.

NPI # 1114292984
LBN Legal business name BEAU SPARKMAN D.D.S., P.A.
Authorized official BEAU SPARKMAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/13/2012
Last updated 03/13/2012 - About 14 years ago
Identifiers
OK License # 6347
OK Medicaid 200343870A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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