Healthcare Provider Details

I. General information

NPI: 1275992281
Provider Name (Legal Business Name): SARAH ELIZABETH SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 03/14/2020
Certification Date: 03/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 N MAUPIN RD
COLBERT OK
74733-1550
US

IV. Provider business mailing address

1313 N 16TH AVE
DURANT OK
74701-2134
US

V. Phone/Fax

Practice location:
  • Phone: 580-579-0443
  • Fax: 580-931-3119
Mailing address:
  • Phone: 580-634-2332
  • Fax: 580-634-2338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: