1891880613 NPI number — WILLIAM HENRY BELL III D.O.

Table of content: WILLIAM HENRY BELL III D.O. (NPI 1891880613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891880613 NPI number — WILLIAM HENRY BELL III D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELL
Provider First Name:
WILLIAM
Provider Middle Name:
HENRY
Provider Name Prefix Text:
Provider Name Suffix Text:
III
Provider Credential Text:
D.O.
Provider Gender Code:
M

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:
1891880613
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1293 E PARKDALE AVE
Provider Second Line Business Mailing Address:
STE L100
Provider Business Mailing Address City Name:
MANISTEE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49660-8904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-398-1957
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
905 NORTH MACOMB STREET SUITE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-242-7212
Provider Business Practice Location Address Fax Number:
734-242-7237
Provider Enumeration Date:
10/04/2006

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: 208600000X , with the licence number:  5101013196 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 03967 . This is a "PARAMOUNT HEALTH CARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0255800335 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 7881252 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4305093 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6891657-001 . This is a "CIGNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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