Provider Demographics
NPI:1548368129
Name:SEXTON, ROY HOWARD III (MD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:HOWARD
Last Name:SEXTON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1750 E KEN PRATT BLVD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-5311
Mailing Address - Country:US
Mailing Address - Phone:720-718-7000
Mailing Address - Fax:970-237-7848
Practice Address - Street 1:1750 E KEN PRATT BLVD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-5311
Practice Address - Country:US
Practice Address - Phone:720-718-7000
Practice Address - Fax:970-237-7848
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC52418207R00000X
FLME87935207R00000X
NV14938208M00000X
CODR.0066538207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269220101Medicaid
CA00C524180Medicaid
FL269220101Medicaid
H93438Medicare UPIN
CA00C524180Medicaid