Provider Demographics
NPI:1972542116
Name:BELL, BARRY (OD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6530 FARMINGTON RD
Mailing Address - Street 2:STE 300
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3216
Mailing Address - Country:US
Mailing Address - Phone:248-661-5100
Mailing Address - Fax:248-661-8816
Practice Address - Street 1:655 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:MADISON HTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1844
Practice Address - Country:US
Practice Address - Phone:248-577-3659
Practice Address - Fax:248-588-9320
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBB002296152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU21474Medicare UPIN