1104927011 NPI number — DR. MARY CATHERINE BELL MD

Table of content: DR. MARY CATHERINE BELL MD (NPI 1104927011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104927011 NPI number — DR. MARY CATHERINE BELL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELL
Provider First Name:
MARY
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104927011
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 428
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CYNTHIANA
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41031-0428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-319-0408
Provider Business Mailing Address Fax Number:
844-245-7851

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CYNTHIANA
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41031-2752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-319-0408
Provider Business Practice Location Address Fax Number:
844-245-7851
Provider Enumeration Date:
09/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  39382 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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