Basic Information
| Provider Information | |||||||||
| NPI: | 1639213051 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CECIL | ||||||||
| FirstName: | DEBBIE | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5410 MARYLAND WAY | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BRENTWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370275064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153775600 | ||||||||
| FaxNumber: | 6153735280 | ||||||||
| Practice Location | |||||||||
| Address1: | 1228 E RUSHOLME ST | ||||||||
| Address2: | SUITE112 | ||||||||
| City: | DAVENPORT | ||||||||
| State: | IA | ||||||||
| PostalCode: | 528032453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5634213121 | ||||||||
| FaxNumber: | 5634213129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/18/2007 | ||||||||
| LastUpdateDate: | 10/14/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 3838 | IA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.