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Organization

KENNETH SANDERS MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANA LYNN SANDERS RN (OFFICE MANAGER)
(318) 797-5602
Entity
Organization

Contact information

Practice address
2800 YOUREE DR, SUITE 110, SHREVEPORT, LA 71104-3661
(318) 861-7533
Mailing address
PO BOX 44072, SHREVEPORT, LA 71134
(318) 797-5602
(318) 797-5600

Taxonomy

Speciality
Code
Description
License number
State
207YS0012X
Sleep Medicine (Otolaryngology) Physician
Primary
022757
LA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
022757
LA

Other

Enumeration date
11/13/2006
Last updated
12/28/2007
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