Individual
MR. KENNETH GARY SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2825 E BARNETT ROAD, MEDFORD, OR 97504-0001
(541) 282-6770
(541) 282-6771
Mailing address
2640 E BARNETT RD, E333, MEDFORD, OR 97504-4301
(541) 282-6770
(541) 282-6771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD27802
OR
207Q00000X
Family Medicine Physician
ME83634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264144500
—
FL
05
—
274568
—
OR
Enumeration date
08/29/2006
Last updated
05/03/2017
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