Individual
CHANNING KYLE SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8120 MAIN ST, SUITE 202, HOUMA, LA 70360-3403
(985) 223-8994
(985) 655-8994
Mailing address
8120 MAIN ST, SUITE 202, HOUMA, LA 70360-3403
(985) 223-8994
(985) 655-8994
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
22360
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1492906
—
LA
Enumeration date
03/24/2006
Last updated
03/18/2019
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