Individual
JILL A FEEZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
713 E ANDERSON ST, WEATHERFORD, TX 76086-5705
(817) 596-8751
Mailing address
PO BOX 8549, FORT WORTH, TX 76124-0549
(817) 451-4208
(817) 563-3699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M3537
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050NS
BCBS
TX
05
—
182748701
—
TX
01
—
8X8163
BCBS
TX
Enumeration date
06/17/2006
Last updated
12/21/2012
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