Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 4254 | OK |
NPI | 1043294861 |
---|---|
Provider Name | Dr. Elisa Depani-Sparkes |
First Address | Oklahoma City, OK 73112-5556 |
Second Address | Edmond, OK 73034-8864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 08/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200077710A | (05) | OK |
I63460 | (02) | OK |