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General NPI Number Information
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NPI Number | 1730974445
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Entity Type | Individual
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Provider Name | CLAYTON THOMAS SEXTON
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Gender | Male
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Dates
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Enumeration Date | 04/12/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 594 RADIO HILL RD
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City | MARION
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State | VA
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Zip | 24354-4224
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Country | US
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Telephone | 423-844-6620
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 W OAKLAND AVE STE 310
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City | JOHNSON CITY
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State | TN
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Zip | 37604-2192
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Country | US
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Telephone | 423-952-2111
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110011269
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 6744
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 0110011269
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 6744
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License Number State | TN
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