1245309335 NPI number — MR. JEFFREY SCOTT SEXTON PA-C

Table of content: MR. JEFFREY SCOTT SEXTON PA-C (NPI 1245309335)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245309335 NPI number — MR. JEFFREY SCOTT SEXTON PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEXTON
Provider First Name:
JEFFREY
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1245309335
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE VANTAGE WAY
Provider Second Line Business Mailing Address:
SUITE B240 MIDDLE TENNESSEE EMERGENCY PHYSICIANS, PC
Provider Business Mailing Address City Name:
NASHVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37228-1562
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-443-7374
Provider Business Mailing Address Fax Number:
615-443-5488

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 N. HIGHLAND AVE
Provider Second Line Business Practice Location Address:
MIDDLE TENNESSEE MEDICAL CENTER
Provider Business Practice Location Address City Name:
MURFREESBORO
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-443-7374
Provider Business Practice Location Address Fax Number:
615-443-5488
Provider Enumeration Date:
11/06/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X , with the licence number:  1442 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)