| Mr Brian Wayne Sparks, PA-C | |
|
407 Gator Cv, Bossier City, LA 71111-8219 | |
| (318) 208-2029 | |
| Not Available |
| Full Name | Mr Brian Wayne Sparks |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 407 Gator Cv, Bossier City, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689907362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA.200306 (Louisiana) | Primary |
| Entity Name | Webster Emergency Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245209527 PECOS PAC ID: 2961448170 Enrollment ID: O20050628000996 |
| Entity Name | Northern Louisiana Emergency Physicians, LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588828172 PECOS PAC ID: 9638246846 Enrollment ID: O20080930000036 |
| Entity Name | WK Red River Cardiovascular Surgeons |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639314271 PECOS PAC ID: 0941363493 Enrollment ID: O20090110000055 |
| Entity Name | Cross Lake Emergency Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013497114 PECOS PAC ID: 5395096440 Enrollment ID: O20180928000987 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Brian Wayne Sparks, PA-C 407 Gator Cv, Bossier City, LA 71111-8219 Ph: (318) 208-2029 | Mr Brian Wayne Sparks, PA-C 407 Gator Cv, Bossier City, LA 71111-8219 Ph: (318) 208-2029 |
Amy J Roks, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2449 Hospital Dr Ste 210, Bossier City, LA 71111 Phone: 318-212-7280 Fax: 318-212-7278 |
Charles Wayne Culpepper, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1518 Doctors Dr, Bossier City, LA 71111 Phone: 318-746-1094 Fax: 318-746-2808 |
Lucas Moncla, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2400 Hospital Dr Ste 130, Bossier City, LA 71111 Phone: 318-212-7990 Fax: 318-212-7995 |
Kerri Lucken Tynes, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2300 Hospital Dr, Suite 450, Bossier City, LA 71111 Phone: 318-752-2328 Fax: 318-746-0160 |
Mr. Paul Allen Ballard, PA-C, ATC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5025 Shed Rd, Bossier City, LA 71111 Phone: 318-798-4623 Fax: 318-795-4742 |
Abigail Davis Bogan, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5341 Airline Dr, Bossier City, LA 71111 Phone: 318-935-1820 |
Kayce Nichols Jones, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2120 Airline Dr, Bossier City, LA 71111 Phone: 318-742-6900 Fax: 318-742-3900 |