MEDICARE: CAITLYN CECIL M.D.

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
1	208000000X	Pediatrics Physician	49173	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225471782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLYN CECIL M.D.

Provider Business Mailing Address
First Line	:	4123 MINNICH AVE
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-4641
Country	:	US
Telephone Number	:	859-608-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	2670 NEW HOLT RD STE C
Second Line	:
City	:	PADUCAH
State	:	KY
Zip	:	42001-7506
Country	:	US
Telephone Number	:	270-575-1010
Fax Number	:	270-575-1018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2013
Last Update Date	:	12/21/2016

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Directions to “ CAITLYN CECIL M.D.” Practice Location

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