Provider Demographics
NPI:1003279779
Name:CECIL, WILLIAM TYLER (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TYLER
Last Name:CECIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WAKE FOREST SCHOOL OF MEDICINE
Mailing Address - Street 2:DEPT OF PSYCHIATRY, MEDICAL CENTER BLVD
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-4551
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PSYCHIATRY
Practice Address - Street 2:791 JONESTOWN ROAD
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1252
Practice Address - Country:US
Practice Address - Phone:336-716-4551
Practice Address - Fax:336-716-9642
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-019232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry