# KENNETH W SANDERS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** K W Sanders MD PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396817722
- **Authorized official:** RON F DAVIS (PARTNER OFFICER)
- **Authorized official phone:** (501) 985-6590

## Contact information

- **Practice address:** 2800 YOUREE DRIVE, SUITE 100A, SHREVEPORT, LA 71104
- **Practice address phone:** (318) 797-5602
- **Practice address fax:** (318) 797-5600
- **Mailing address:** PO BOX 44072, SHREVEPORT, LA 71134
- **Mailing address phone:** (318) 797-5602
- **Mailing address fax:** (318) 797-5600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 207YS0012X | Sleep Medicine (Otolaryngology) Physician | — | NULL | Yes |
| 207YS0012X | Sleep Medicine (Otolaryngology) Physician | — | — | Yes |
| 207YS0123X | Facial Plastic Surgery Physician | — | NULL | — |
| 207YS0123X | Facial Plastic Surgery Physician | — | — | — |
| 207YX0901X | Otology & Neurotology Physician | — | NULL | — |
| 207YX0901X | Otology & Neurotology Physician | — | — | — |
| 235500000X | Speech/Language/Hearing Specialist/Technologist | — | NULL | — |
| 235500000X | Speech/Language/Hearing Specialist/Technologist | — | — | — |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 09/11/2025