Basic Information
| Provider Information | |||||||||
| NPI: | 1548368129 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEXTON | ||||||||
| FirstName: | ROY | ||||||||
| MiddleName: | HOWARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1750 E KEN PRATT BLVD | ||||||||
| Address2: | |||||||||
| City: | LONGMONT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805045311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7207187000 | ||||||||
| FaxNumber: | 9702377848 | ||||||||
| Practice Location | |||||||||
| Address1: | 1750 E KEN PRATT BLVD | ||||||||
| Address2: | |||||||||
| City: | LONGMONT | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805045311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7207187000 | ||||||||
| FaxNumber: | 9702377848 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C52418 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME87935 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 14938 | NV | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | DR.0066538 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 269220101 | 05 | FL | MEDICAID | 00C524180 | 05 | CA | MEDICAID |