MEDICARE: DR. JAMIE LEE SEXTON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	27195	TN
2	183500000X	Pharmacist	10315	AR

General Provider Information

NPI Number	:	1598979767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE LEE SEXTON PHARMD

Provider Business Mailing Address
First Line	:	1640 CENTURY CENTER PKWY
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-8822
Country	:	US
Telephone Number	:	901-747-0349
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 CENTURY CENTER PKWY
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-8822
Country	:	US
Telephone Number	:	901-747-0349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	05/10/2011

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