Provider Demographics
NPI:1437152279
Name:SEXTON, MICHAEL A (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:SEXTON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 KENTUCKY AVE
Mailing Address - Street 2:DOB 3, SUITE 601
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3800
Mailing Address - Country:US
Mailing Address - Phone:270-408-4368
Mailing Address - Fax:270-408-3272
Practice Address - Street 1:2605 KENTUCKY AVE
Practice Address - Street 2:DOB 3, SUITE 601
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3800
Practice Address - Country:US
Practice Address - Phone:270-408-4368
Practice Address - Fax:270-408-3272
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0449231H00000X
KY0632237700000X
KYKY-0449237600000X
KYKY-0917231H00000X
237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000614199OtherKY BCBS
KY1437152279OtherNPI
KY70001227Medicaid
KY70001227Medicaid