Individual
DR. CODY JAMES SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
342231
LA
207XP3100X
Pediatric Orthopaedic Surgery Physician
2022010832
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111990
—
MO
Enumeration date
03/27/2017
Last updated
02/06/2026
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