Provider Demographics
NPI:1932568821
Name:SEXTON, TREVOR (ND)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:
Last Name:SEXTON
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 6TH DR
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-4627
Mailing Address - Country:US
Mailing Address - Phone:928-985-0242
Mailing Address - Fax:
Practice Address - Street 1:580 E OLD LINDEN RD
Practice Address - Street 2:STE #4
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-4817
Practice Address - Country:US
Practice Address - Phone:928-985-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ161527175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath