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Contact Information

KENNETH W SANDERS, MD
8711 LINE AVE
SHREVEPORT, LA71106-6813
 Phone: 318-698-8711
 Fax: 318-988-6766
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for KENNETH W SANDERS · (Male)

NPI # 1427080043
Status Active
Credentials MD
Entity Individual
Enumeration date 07/06/2006
Last updated 09/30/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • LA License # 022757
  • LA Medicaid 1686735
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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