Individual
DR. KENNETH NEIL SANSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
930 NW JONES AVE, ALBANY, OR 97321-1314
(541) 926-3922
Mailing address
930 NW JONES AVE, ALBANY, OR 97321-1314
(541) 926-3922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD26778
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0509356
IA MA
IA
01
—
080120567
RR MEDICARE
—
05
—
260270900
—
MN
Enumeration date
08/21/2006
Last updated
12/08/2015
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