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NPI Code Detail

MEDICARE: CECELIA E HALE DO

MEDICARE: CECELIA E HALE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine Physician02008225AIN

General Provider Information

NPI Number : 1215631288
Entity Type Code : Individual
Provider Name (Legal Business Name) : CECELIA E HALE DO
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11109 PARKVIEW PLAZA DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number : 260-672-6620
Fax Number : 260-672-6639
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2023
Last Update Date : 06/29/2026

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Directions to “ CECELIA E HALE DO” Practice Location

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