Provider Demographics
NPI:1164415550
Name:BELL, AMY E (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:E
Last Name:BELL
Suffix:
Gender:F
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:N89W16811 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2038
Mailing Address - Country:US
Mailing Address - Phone:262-251-1570
Mailing Address - Fax:
Practice Address - Street 1:N89W16811 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2038
Practice Address - Country:US
Practice Address - Phone:262-251-1570
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2550152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38594300Medicare ID - Type Unspecified
WIU42288Medicare UPIN
WI47375Medicare ID - Type Unspecified