Provider Demographics
NPI:1013412329
Name:SEXTON, AMBER DAWN (DO)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:DAWN
Last Name:SEXTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1179
Mailing Address - Country:US
Mailing Address - Phone:606-783-6455
Mailing Address - Fax:606-783-6392
Practice Address - Street 1:390 S KY 7
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:KY
Practice Address - Zip Code:41171-6830
Practice Address - Country:US
Practice Address - Phone:606-738-5155
Practice Address - Fax:606-738-5420
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY390200000X
KY04999207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY04999OtherKY MEDICAL LICENSE