Provider Demographics
NPI:1154379535
Name:BELL-SIMMONS, STACY MICHELE (OD)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:MICHELE
Last Name:BELL-SIMMONS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:STACY
Other - Middle Name:MICHELE
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:6095 N NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64152
Mailing Address - Country:US
Mailing Address - Phone:816-891-8614
Mailing Address - Fax:
Practice Address - Street 1:2525 N BELT HWY
Practice Address - Street 2:THE SPEC SHOPPE
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506
Practice Address - Country:US
Practice Address - Phone:816-364-0450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002000795152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist