Provider Demographics
NPI:1154679561
Name:BELL, LUCAS J (OD)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:J
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 1:270W 1ST ST H
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-2145
Mailing Address - Country:US
Mailing Address - Phone:515-320-1375
Mailing Address - Fax:
Practice Address - Street 1:270W 1ST ST H
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-2145
Practice Address - Country:US
Practice Address - Phone:515-986-2821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2015-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002557152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist