KENNETH WAYNE SANDERS MD NPI 1427080043

NPI Information

  • NPI: 1427080043
  • Provider Name: KENNETH WAYNE SANDERS, MD
  • Classification: Otolaryngology - 207YX0007X
  • Specialization: Plastic Surgery within the Head & Neck
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8711 LINE AVE
    SHREVEPORT, LA
    ZIP 71106
  • Phone: (318) 698-8711

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NPI Details

Kenneth Wayne Sanders, MD is a plastic surgery within the head and neck otolaryngology in Shreveport, LA. The provider is an otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. Kenneth Wayne Sanders, MD NPI is 1427080043. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8711 LINE AVE
SHREVEPORT, LA
ZIP 71106-813
Phone: (318) 698-8711
Fax: (318) 988-6766

The NPI 1427080043 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 9/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207YX0007XOtolaryngologyPlastic Surgery within the Head & Neck022757LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11686735MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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