Healthcare Provider Details
I. General information
NPI: 1255483046
Provider Name (Legal Business Name): ROBERT L SEXTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
322 W NORTH RIVER DR
SPOKANE WA
99201-3208
US
IV. Provider business mailing address
PO BOX 34584
SEATTLE WA
98124-1584
US
V. Phone/Fax
- Phone: 509-324-6464
- Fax:
- Phone: 509-241-7349
- Fax: 509-241-7628
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD00018025 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: