Provider Demographics
NPI:1194761783
Name:BELL, PHILIP J (DO)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:BELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:6445 VINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19139-1036
Mailing Address - Country:US
Mailing Address - Phone:215-748-0505
Mailing Address - Fax:215-748-4090
Practice Address - Street 1:6445 VINE STREET
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19139-1036
Practice Address - Country:US
Practice Address - Phone:215-748-0505
Practice Address - Fax:215-748-4090
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002235L207Q00000X
PAOS002235-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005906870001Medicaid
PA000596870001Medicaid
PA0005906870001Medicaid
PA41657Medicare PIN
D66287Medicare UPIN