Healthcare Provider Details

I. General information

NPI: 1720027626
Provider Name (Legal Business Name): JANE A CECIL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E MARSHALL ST VCUHS
RICHMOND VA
23298-5048
US

IV. Provider business mailing address

PO BOX 980049
RICHMOND VA
23298-0049
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9711
  • Fax: 804-828-3097
Mailing address:
  • Phone: 804-828-9711
  • Fax: 804-828-3097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number0101227523
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: