Provider Demographics
NPI:1053316406
Name:BELL, GERALD SCOTT (OD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:SCOTT
Last Name:BELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4822 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2108
Mailing Address - Country:US
Mailing Address - Phone:412-683-1020
Mailing Address - Fax:412-683-2050
Practice Address - Street 1:4822 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2108
Practice Address - Country:US
Practice Address - Phone:412-683-1020
Practice Address - Fax:412-683-2050
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-000595152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABE901424Medicare ID - Type Unspecified
PAU66893Medicare UPIN