Healthcare Provider Details

I. General information

NPI: 1013783323
Provider Name (Legal Business Name): SEXTON-OMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 AARON BRENNER DR STE 105
MEMPHIS TN
38120-1467
US

IV. Provider business mailing address

1661 AARON BRENNER DR STE 105
MEMPHIS TN
38120-1467
US

V. Phone/Fax

Practice location:
  • Phone: 901-756-8475
  • Fax: 901-756-7820
Mailing address:
  • Phone: 901-756-8475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN BARRETT SEXTON
Title or Position: ORAL SURGEON
Credential: DDS
Phone: 901-756-8475