Provider Type Icon

KENNETH W. SANDERS MD AND WILLIS-KNIGHTON MEDICAL CENTER NPI 1912936196


NPI Information

NPI: 1912936196
Provider Name: KENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER
Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
1811 EAST BERT KOUNS
SUITE 160
SHREVEPORT, LA
ZIP 71105
Phone: (318) 212-3223
Get Directions

KENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER is a plastic and reconstructive surgery surgery in Shreveport, LA. The provider is a surgeon who specializes in plastic and reconstructive surgery. KENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER NPI is 1912936196. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1811 EAST BERT KOUNS
SUITE 160
SHREVEPORT, LA
ZIP 71105-505
Phone: (318) 212-3223
Fax: (318) 212-3989

The provider's authorized official is Greg J. Gavin .
The authorized official title is Network Administrator and has the following contact phone number (318) 212-3223.

The enumeration date for this NPI number is 7/1/2006 and was last updated on 6/8/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0122XSurgeryPlastic and Reconstructive SurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15CM96MEDICARE PINLOUISIANA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.