Healthcare Provider Details

I. General information

NPI: 1750345997
Provider Name (Legal Business Name): JOEL S. SEXTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2669 KINARD ST
NEWBERRY SC
29108-2911
US

IV. Provider business mailing address

PO BOX 49009
GREENWOOD SC
29649-0001
US

V. Phone/Fax

Practice location:
  • Phone: 803-276-7570
  • Fax:
Mailing address:
  • Phone: 864-223-3070
  • Fax: 864-223-1396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number5559
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number5559
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: