Provider Demographics
NPI:1891808713
Name:SANDERS, RONALD C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:C
Last Name:SANDERS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:CARY
Other - Last Name:SANDERS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 CHILDRENS WAY # 512-12
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-4166
Mailing Address - Fax:501-364-3188
Practice Address - Street 1:1 CHILDRENS WAY # 512-12
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-4166
Practice Address - Fax:501-364-3188
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME871242080P0203X
ARE-13182080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR172777001Medicaid
FL263955600Medicaid
AR172777001Medicaid
FL263955600Medicaid
F86591Medicare UPIN
FL12034ZMedicare PIN