Organization
CECIL CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN T CECIL JR. MD (SOLE MEMBER)
(270) 575-1010
Entity
Organization
Contact information
Practice address
2670 NEW HOLT RD STE C, PADUCAH, KY 42001-7506
(270) 575-1010
(270) 575-1018
Mailing address
PO BOX 14252, BELFAST, ME 04915-4035
(270) 575-1010
(270) 575-1018
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
PA403
KY
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100217070
—
KY
05
—
7100217100
—
KY
Enumeration date
09/07/2012
Last updated
12/20/2016
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