Healthcare Provider Details

I. General information

NPI: 1962723809
Provider Name (Legal Business Name): JONATHAN J SEXTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 434-243-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number39516
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number39516
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number0101273175
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: