Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | E3088 | AR |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | E-3088 | AR |
NPI | 1225128796 |
---|---|
Provider Name | Dr. Kenneth Morgan Sauer |
First Address | Little Rock, AR 72205-2901 |
Second Address | Little Rock, AR 72205-6321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 04/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
154126001 | (05) | AR |
I04767 | (02) | AR |
P00129141 | RAILROAD MEDICARE (01) | AR |