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General NPI Number Information
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NPI Number | 1093868564
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Entity Type | Organization
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Legal Business Name | JENNIFER D CECIL MD PLLC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 2902 GINNALA DR SUITE 1
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City | LOVELAND
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State | CO
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Zip | 80538-7817
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Country | US
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Telephone | 970-669-8998
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Fax | 970-669-8693
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Provider Business Mailing Address
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Address Line | 2902 GINNALA DR SUITE 1
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City | LOVELAND
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State | CO
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Zip | 80538-7817
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Country | US
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Telephone | 970-669-8998
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Fax | 970-669-8693
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER DIANE CECIL
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Credential | M.D.
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Telephone | 970-669-8998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 32604
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License Number State | CO
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