Healthcare Provider Details

I. General information

NPI: 1982772703
Provider Name (Legal Business Name): JENNIFER ANN SEXTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER ANN SPITLER MD

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 NEALY AVE
HAMPTON VA
23665-2040
US

IV. Provider business mailing address

77 NEALY AVE
HAMPTON VA
23665-2040
US

V. Phone/Fax

Practice location:
  • Phone: 757-764-8252
  • Fax:
Mailing address:
  • Phone: 757-764-8252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2006005294
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD036941
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number22462
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: