Healthcare Provider Details

I. General information

NPI: 1124849476
Provider Name (Legal Business Name): ADAM SEXTON PT,DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 10/21/2024
Certification Date: 10/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 SOLITUDE DR
SOMERSET KY
42503-4929
US

IV. Provider business mailing address

57 SOLITUDE DR
SOMERSET KY
42503-4929
US

V. Phone/Fax

Practice location:
  • Phone: 606-341-4020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number007574
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: