Provider Demographics
NPI:1174597124
Name:BELL, ROBERT E (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:BELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:619 S MARION AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-5808
Mailing Address - Country:US
Mailing Address - Phone:386-755-3016
Mailing Address - Fax:386-719-3622
Practice Address - Street 1:619 S MARION AVE
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-5808
Practice Address - Country:US
Practice Address - Phone:386-755-3016
Practice Address - Fax:386-719-3622
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2015-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO46365207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO67477542Medicaid
G31594Medicare UPIN
CO67477542Medicaid
CO67477542Medicaid