KENNETH WAYNE SANDERS (NPI# 1427080043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427080043 |
| Entity Type | Individual |
| Full Name | KENNETH WAYNE SANDERS |
| Credential | MD |
| Practice Address |
8711 Line Ave Shreveport LA 71106-6813 |
| Mailing Address |
1811 E Bert Kouns Industrial Loop Suite 160 Shreveport LA 71105-5740 |
| Practice Telephone | 3186988711 |
| Practice Fax Number | 3189886766 |
| Mailing Telephone | 3182123223 |
| Mailing Fax Number | 3182123989 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2019-09-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0007X |
Otolaryngology Specialization: Plastic Surgery within the Head & Neck |
022757 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1686735 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972614550 | Kenneth Ira Sanders | Chiropractor | 7365 Carnelian St Ste 134, Rancho Cucamonga, CA 91730-1100 | 2006-08-31 |
| 1871039081 | Kenneth Dean Sanders | Substance Abuse Rehabilitation Facility | 3107 E Kaweah Ave, Visalia, CA 93292-3309 | 2017-01-11 |
| 1265845309 | Kenneth Sanders IIi | Pharmacist | 1031 Armory Dr, Franklin, VA 23851-1851 | 2014-06-06 |
| 1730267550 | Kenneth C. Sanders | Emergency Medicine | 975 Sereno Dr, Vallejo, CA 94589-2441 | 2006-11-01 |
| 1033137369 | Kenneth D Sanders | Anesthesiology | 619 19th Street South, Birmingham, AL 35233 | 2006-07-17 |
| 1578502696 | Kenneth Michael Sanders | Physician Assistant | 923 E Central Ave, La Follette, TN 37766-2768 | 2006-06-05 |
| 1275501777 | Kenneth Sanders | Orthopaedic Surgery | 100 Spalding Dr, 3rd Floor, Naperville, IL 60540-6550 | 2006-03-09 |
| 1023018405 | Kenneth L. Sanders | Physician Assistant | 5201 Harry Hines Blvd, Medical Staff Services, Dallas, TX 75235-7708 | 2005-07-27 |
| Street Address |
8711 LINE AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-6813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174863336 | Slsc Medical Staff | Clinic/Center | 8711 Line Ave, Shreveport, LA 71106-6813 | 2013-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 207YX0007X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Plastic Surgery within the Head & Neck |
| An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy is currently provided in the subspecialty of Otolaryngology/Facial Plastic Surgery (see Taxonomy Code 207YX0905X) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124516844 | Sean R. Weiss, Md, LLC | Otolaryngology | 2201 Veterans Memorial Blvd Ste 408, Metairie, LA 70002-6326 | 2018-04-27 |
| 1659807972 | Mohamed Ahmed Shama | Otolaryngology | 1430 Tulane Ave Rm 8510-b, New Orleans, LA 70112-2632 | 2017-05-05 |
| 1972840692 | Joseph Aaron Roy | Otolaryngology | 2720 Bocage Lake Dr, Baton Rouge, LA 70809-1051 | 2013-01-15 |
| 1275843088 | Michael C. Jones, M.d., LLC | Otolaryngology | 1629 S. Beglis Parkway, Sulphur, LA 70663-5906 | 2010-10-14 |
| 1639401656 | Edward Bruce Edrington | Otolaryngology | 44 Farnham Place, Metairie, LA 70005 | 2010-02-01 |
| 1861461444 | Dennis Anderson Casey IIi | Otolaryngology | 4022 Canal St, New Orleans, LA 70119-6021 | 2006-03-16 |
| 1760464440 | Michael Craig Jones | Otolaryngology | 1629 S Beglis Parkway, Sulphur, LA 70663 | 2005-11-17 |
| 1396068318 | Elise Scallan Md LLC | Otolaryngology | 8080 Bluebonnet Blvd, Suite 2121, Baton Rouge, LA 70810-7827 | 2010-03-04 |
| 1720262108 | Akash Gujral Anand | Otolaryngology | 4224 Houma Blvd, Suite 205, Metairie, LA 70006-2933 | 2007-12-20 |
| 1831280668 | Ronald Gerard Amedee | Otolaryngology | 1514 Jefferson Highway, New Orleans, LA 70121 | 2006-09-27 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.