Healthcare Provider Details

I. General information

NPI: 1467533992
Provider Name (Legal Business Name): HAROLD COREY SEXTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HAROLD SEXTON MD

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 11/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 NE COURTNEY DR
BEND OR
97701-7638
US

IV. Provider business mailing address

1652 NW SUMMIT DR
BEND OR
97701-5624
US

V. Phone/Fax

Practice location:
  • Phone: 541-322-7400
  • Fax:
Mailing address:
  • Phone: 541-324-0396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD 07220
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13246
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: