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General NPI Number Information
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NPI Number | 1205952645
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Entity Type | Individual
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Provider Name | JOHNNIE EDWIN SEXTON M.S.,CCC-A
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 BATTLEGROUND AVE
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City | GREENSBORO
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State | NC
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Zip | 27408-8042
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Country | US
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Telephone | 336-373-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 328 E RENOVAH CIR
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City | WILMINGTON
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State | NC
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Zip | 28403-1226
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Country | US
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Telephone | 910-233-0994
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 961
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License Number State | NC
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