Provider Demographics
NPI:1497716310
Name:LOVELL, CECIL WILLIAM III (MD)
Entity Type:Individual
Prefix:DR
First Name:CECIL
Middle Name:WILLIAM
Last Name:LOVELL
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13841 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-3436
Mailing Address - Country:US
Mailing Address - Phone:225-753-0862
Mailing Address - Fax:225-752-9420
Practice Address - Street 1:13841 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-3436
Practice Address - Country:US
Practice Address - Phone:225-753-0862
Practice Address - Fax:225-752-9420
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2013-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA016351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB89194Medicare UPIN
LA5L793Medicare PIN