Provider Demographics
NPI:1699088732
Name:SANDERS, KIRK STAFFORD (MD)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:STAFFORD
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 HOSPICE DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:NC
Mailing Address - Zip Code:27016-7379
Mailing Address - Country:US
Mailing Address - Phone:336-593-8281
Mailing Address - Fax:
Practice Address - Street 1:1020 HOSPICE DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:NC
Practice Address - Zip Code:27016-7379
Practice Address - Country:US
Practice Address - Phone:336-593-8281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-01507207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine