Basic Information
| Provider Information | |||||||||
| NPI: | 1376572230 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPARROW | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | G. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 15004 | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655229730 | ||||||||
| FaxNumber: | 8656372520 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 DUTCH VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8656891122 | ||||||||
| FaxNumber: | 8656892923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2006 | ||||||||
| LastUpdateDate: | 06/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD24121 | TN | Y | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0204X | MD24121 | TN | N | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3023583 | 01 | TN | BCBS | OTHER | 3036621 | 01 | TN | BLUE CROSS | OTHER | 3072796 | 05 | TN | MEDICAID | 64914328 | 05 | KY | MEDICAID |