Sparks, Kelly L.

Sparks, Kelly L. is an individual health care provider with primary practice located at 109 Bridge St Ste 300 , Danville VA 24541-1222. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Sparks, Kelly L. can be contacted via phone (434) 793-4711.

Contact Information

Primary practice address
109 Bridge St Ste 300 Danville VA 24541-1222
Phone: (434) 793-4711
Fax: (434) 797-2514
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X Virginia
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110007007 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10000928A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 85080096 Illinois

Profile Details

NPI number 1649245309
LBN Legal business name Sparks, Kelly L.
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Aug 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649245309 NPPES
Virginia Other VVX692A MEDICARE
Virginia Other 0110007007 MEDICARE

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