Basic Information
Provider Information
NPI: 1184604563
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEXTON
FirstName: THOMAS
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 435 HURFFVILLE CROSS KEYS RD
Address2:  
City: TURNERSVILLE
State: NJ
PostalCode: 080122453
CountryCode: US
TelephoneNumber: 8562185634
FaxNumber: 8562185664
Practice Location
Address1: 435 HURFFVILLE CROSS KEYS RD
Address2:  
City: TURNERSVILLE
State: NJ
PostalCode: 080122453
CountryCode: US
TelephoneNumber: 8562185634
FaxNumber: 8562185664
Other Information
ProviderEnumerationDate: 01/20/2006
LastUpdateDate: 02/20/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMB06948800NJY Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X25MB06948800NJN Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
799240805NJ MEDICAID


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