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KENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER
NPI 1912936196
Surgery - Plastic and Reconstructive Surgery in Shreveport, LA

Active since July 01, 2006
1811 EAST BERT KOUNS, SUITE 160, SHREVEPORT, LA 71105(318) 212-3223(318) 212-3989 Get Directions Write a Review

NPPES record last updated: June 8, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenneth W. Sanders, Md And Willis-knighton Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER (NPI 1912936196) is a healthcare organization registered as a plastic and reconstructive surgery in Shreveport, Louisiana and active in the NPI registry since July 2006. The organization lists Greg J. Gavin, Network Administrator, as its authorized official.

NPPES Registry Identity

NPI1912936196
Entity TypeOrganization
Primary Taxonomy2086S0122X
Legal Business NameKENNETH W. SANDERS, MD AND WILLIS-KNIGHTON MEDICAL CENTER
Location Address1811 EAST BERT KOUNS, SUITE 160Shreveport, LA 71105-5505
Mailing Address1811 East Bert Kouns, Suite 160Shreveport, LA 71105-5505 · (318) 212-3223 · Fax (318) 212-3989
Phone(318) 212-3223
Fax(318) 212-3989
Organization SubpartNo
Authorized OfficialGreg J. GavinNetwork Administrator · (318) 212-3223
Enumeration DateJuly 1, 2006
Last NPPES UpdateJune 8, 2012
✔ NPI 1912936196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
Definition
A surgeon who specializes in plastic and reconstructive surgery.
1811 EAST BERT KOUNS, Shreveport, LA 71105
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Other Identifiers 1

Medicare PIN5CM96LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ABBEY M. CARROLL MD
Pediatrics
1811 EAST BERT KOUNS, SUITE 140
SHREVEPORT, LA 71105
Caddo Parish (318) 212-3900
KENNETH W. SANDERS, MD LLC
Otolaryngology (Facial Plastic Surgery)
1811 EAST BERT KOUNS, SUITE 160
SHREVEPORT, LA 71105
Caddo Parish (318) 212-3223

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth W. Sanders, MD And Willis-Knighton Medical Center's NPI number?

The NPI number for Kenneth W. Sanders, MD And Willis-Knighton Medical Center is 1912936196. It was assigned to this organization in the NPPES registry on July 1, 2006.

Where is Kenneth W. Sanders, MD And Willis-Knighton Medical Center located?

Kenneth W. Sanders, MD And Willis-Knighton Medical Center is located at 1811 East Bert Kouns Suite 160, Shreveport, LA 71105. The listed phone number is (318) 212-3223.

What is Kenneth W. Sanders, MD And Willis-Knighton Medical Center's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

When was this NPI record last updated?

The NPPES record for Kenneth W. Sanders, MD And Willis-Knighton Medical Center was last updated on June 8, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.