Individual
KENNETH D SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
22046
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010033CH56058
SECTION 1011
AL
01
—
125546
MISSISSIPPI MEDICAID
MS
01
—
50085770
RAILROAD MEDICARE
AL
Enumeration date
07/17/2006
Last updated
07/08/2007
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