Healthcare Provider Details

I. General information

NPI: 1013721125
Provider Name (Legal Business Name): TYLER L SEXSON DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S BROADWAY ST
LOUISBURG KS
66053-3613
US

IV. Provider business mailing address

15 S BROADWAY ST
LOUISBURG KS
66053-3613
US

V. Phone/Fax

Practice location:
  • Phone: 913-837-2910
  • Fax: 913-837-2911
Mailing address:
  • Phone: 913-837-2910
  • Fax: 913-837-2911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-06386
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: