Healthcare Provider Details

I. General information

NPI: 1063040897
Provider Name (Legal Business Name): SHAWN SEXTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 E JEFFERSON ST STE 106
IOWA CITY IA
52245-2479
US

IV. Provider business mailing address

540 E JEFFERSON ST STE 106
IOWA CITY IA
52245-2479
US

V. Phone/Fax

Practice location:
  • Phone: 319-354-2653
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351050251
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD-57105
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: