Healthcare Provider Details

I. General information

NPI: 1104009950
Provider Name (Legal Business Name): SEXTON FAMILY CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2007
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2747 BLANDING BLVD SUITE 104
MIDDLEBURG FL
32068-5652
US

IV. Provider business mailing address

2747 BLANDING BLVD SUITE 104
MIDDLEBURG FL
32068-5652
US

V. Phone/Fax

Practice location:
  • Phone: 904-282-3917
  • Fax: 904-282-3192
Mailing address:
  • Phone: 904-282-3917
  • Fax: 904-282-3192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. TIMOTHY LEE SEXTON
Title or Position: OWNER
Credential: D.C.
Phone: 904-282-3917