Individual
DR. SUZANNE MARIE CECCONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
81ST MEDICAL GROUP/SGOC, 301 FISHER ST. ROOM 1A-132, KEESLER AFB, MS 39534
(228) 376-0402
(228) 376-0198
Mailing address
301 FISHER ST, KEESLER MEDICAL CENTER, KEESLER AFB, MI 39534
(228) 376-0402
(228) 376-0198
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
00024934
AL
208000000X
Pediatrics Physician
G85948
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00024934
MEDICAL LICENSE
AL
01
—
G85948
MEDICAL LICENSE
CA
Enumeration date
05/09/2006
Last updated
10/29/2007
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