Provider Demographics
NPI:1851375158
Name:BELL, JEFFREY D (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3264 N. NORTH HILLS BLVD.
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4005
Mailing Address - Country:US
Mailing Address - Phone:479-521-3300
Mailing Address - Fax:479-521-4914
Practice Address - Street 1:3264 N. NORTH HILLS BLVD.
Practice Address - Street 2:377TH MEDICAL GROUP
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4005
Practice Address - Country:US
Practice Address - Phone:479-521-3300
Practice Address - Fax:479-521-4914
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2002-0497208600000X
TXK7658208600000X
ARE4752208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR163164001Medicaid
AR5N539Medicare PIN
AR163164001Medicaid