Provider Demographics
NPI:1326208208
Name:TIMOTHY A. BELLA, M.D.
Entity Type:Organization
Organization Name:TIMOTHY A. BELLA, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-272-0106
Mailing Address - Street 1:10127 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-1765
Mailing Address - Country:US
Mailing Address - Phone:225-272-0106
Mailing Address - Fax:225-275-4558
Practice Address - Street 1:10127 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-1765
Practice Address - Country:US
Practice Address - Phone:225-272-0106
Practice Address - Fax:225-275-4558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA019503207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA55013Medicare PIN
LAD87006Medicare UPIN