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Organization
SPRING LAKE SURGERY CENTER, LLC
Active
Organization
SPRING LAKE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH W SANDERS MD (MD)
(318) 841-4486
Entity
Organization
Contact information
Practice address
8711 LINE AVENUE, SHREVEPORT, LA 71106
(318) 841-4486
(318) 841-4489
Mailing address
8711 LINE AVE, SHREVEPORT, LA 71106-6813
(318) 841-4486
(318) 841-4489
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
017152
LA
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
06/16/2006
Last updated
03/06/2020
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