Provider Demographics
NPI:1215631288
Name:HALE, CECELIA E (DO)
Entity type:Individual
Prefix:
First Name:CECELIA
Middle Name:E
Last Name:HALE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CECELIA
Other - Middle Name:E
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2231 CAREW ST
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-4713
Mailing Address - Country:US
Mailing Address - Phone:260-373-7760
Mailing Address - Fax:
Practice Address - Street 1:2231 CAREW ST
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-4713
Practice Address - Country:US
Practice Address - Phone:260-373-7765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program