Individual
KENT D SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 MACK RD, FAIRFIELD, OH 45014-5335
(513) 870-7001
(513) 603-8174
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35049641
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000385327
BCBS FAIRFIELD
OH
05
—
0534185
—
OH
01
—
P00315085
RR MEDICARE FAIRFIELD
—
Enumeration date
06/06/2006
Last updated
10/18/2007
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