Healthcare Provider Details

I. General information

NPI: 1053420950
Provider Name (Legal Business Name): CURTIS CECIL SEXTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 INDEPENDENCE LN
LA FOLLETTE TN
37766-3031
US

IV. Provider business mailing address

198 DABNEY LN P O BOX 670
LAKE CITY TN
37769-5946
US

V. Phone/Fax

Practice location:
  • Phone: 423-562-1705
  • Fax: 423-566-3718
Mailing address:
  • Phone: 865-494-8023
  • Fax: 865-494-6382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD004676
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: