Provider Demographics
NPI:1124002191
Name:BELL, DON ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:ANTONIO
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 1:2233 N LONGVIEW PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-1296
Mailing Address - Country:US
Mailing Address - Phone:208-577-6892
Mailing Address - Fax:
Practice Address - Street 1:190 E BANNOCK
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712
Practice Address - Country:US
Practice Address - Phone:208-381-2094
Practice Address - Fax:208-381-1791
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC94-004142085N0700X
SC195892085N0700X
NC94004142085R0202X
IDM102302085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID808147000Medicaid
NC8914455Medicaid
NCF33262Medicare UPIN
F33262Medicare UPIN
NC2216995AMedicare ID - Type Unspecified