Cecil J Fackrell in Shawnee - Physician Assistant
Cecil J Fackrell - NPI 1174646400
Cecil J Fackrell is a Physician Assistant in Shawnee, Kansas. Cecil J Fackrell practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Cecil J Fackrell is 1174646400. The last update date is 2017-03-15.
Cecil J Fackrell's current location address is 6333 Long Ave, Shawnee, Kansas. You can contact this provider via phone number 9136316330 and fax number 9136316222. The mailing address for Cecil J Fackrell is 6333 Long Ave, Shawnee, Kansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Cecil J Fackrell |
|---|---|
| Address | 6333 Long Ave, Shawnee, Kansas |
| Phone Number | 9136316330 |
| Fax Number | 9136316222 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1174646400 |
|---|---|
| Provider Enumeration Date | 2007-04-10 |
| Last Updated Date | 2017-03-15 |
Provider Mailing Address Detail
| Address | 6333 Long Ave |
|---|---|
| City | Shawnee |
| State | Kansas (KS) |
| Post Code | 662162500 |
| Phone Number | 9136316330 |
| Fax Number | 9136316222 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 15-01306 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique identifier code issued to Cecil J Fackrell by the Centers for Medicare & Medicaid Services?
The Cecil J Fackrell has been assigned the NPI (National Provider Identifier) 1174646400. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Cecil J Fackrell located?
The Cecil J Fackrell is located at 6333 Long Ave, Shawnee, KS 662162500.
What is the Cecil J Fackrell's specialty and taxonomy code?
The Cecil J Fackrell's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
On what date did the Cecil J Fackrell receive its 1174646400 assignment from the Centers for Medicare & Medicaid Services?
The Cecil J Fackrell was assigned its 1174646400 by the Centers for Medicare & Medicaid Services on 2007-04-10.
When was the information regarding Cecil J Fackrell most recently updated?
The details pertaining to the Cecil J Fackrell, including its address, specialty, and other relevant information, were last refreshed on 2017-03-15.