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NPI Code Detail

MEDICARE: MR. JAMES RICHARD SEXTON PHYSICIAN ASSISTANT

MEDICARE:  MR. JAMES RICHARD SEXTON  PHYSICIAN ASSISTANT
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
1363A00000XPhysician Assistant626AK

General Provider Information

NPI Number : 1770789620
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES RICHARD SEXTON PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : PO BOX 269
Second Line :
City : GOLDENDALE
State : WA
Zip : 98620-0269
Country : US
Telephone Number : 509-773-6612
Fax Number :
Provider Business Practice Location Address
First Line : 3400 SPENARD RD STE 105
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-3710
Country : US
Telephone Number : 907-392-3550
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 07/08/2007

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Directions to “ MR. JAMES RICHARD SEXTON PHYSICIAN ASSISTANT” Practice Location

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