Provider Demographics
NPI:1487658969
Name:SEXTON, DAVID G (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:G
Last Name:SEXTON
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:PO BOX 31547
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-1547
Mailing Address - Country:US
Mailing Address - Phone:865-693-6065
Mailing Address - Fax:865-531-6325
Practice Address - Street 1:9430 PARK WEST BLVD
Practice Address - Street 2:STE 330
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4203
Practice Address - Country:US
Practice Address - Phone:865-693-6065
Practice Address - Fax:865-531-6325
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13649207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3019629Medicaid
TN3019629Medicaid
3019627Medicare PIN