Kenneth W. Sanders, MD and Willis-Knighton Medical Center

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

KENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER

Practice address

1811 East Bert Kouns
Suite 160
Shreveport, LA 71105-5505

Phone

(318) 212-3223

Fax

(318) 212-3989

NPI assigned

Jul 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Greg J. Gavin

Title

Network Administrator

Phone

(318) 212-3223

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  dba WK Renal Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Shreveport, LA
  • NPI 1003020579

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1912936196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 EAST BERT KOUNS",
            "address_2": "SUITE 160",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-212-3223",
            "fax_number": "318-212-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 EAST BERT KOUNS",
            "address_2": "SUITE 160",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055505",
            "telephone_number": "318-212-3223",
            "fax_number": "318-212-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-3223"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia T Kennedy, FNP
• Robert Craig Kennedy, LPC
• Sherry Kennedy, RN
• Kenneth Sanders MD PLLC
• Kenneth W Sanders PLLC
• Kenneth W. Sanders, MD LLC
• Robert A Kenney III, PT
• Jeffrey Lynn Kennington, RN
• Debra Kennon
• Jadebrey Vyshette Kennon, PMHNP-BC

• Plastic and Reconstructive Surgery Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Plastic and Reconstructive Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.