Provider Demographics
NPI:1407859614
Name:BELL, HAROLD BRUCE (OD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:BRUCE
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 1:518 - 200 COLLEGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-1430
Mailing Address - Country:US
Mailing Address - Phone:864-654-7980
Mailing Address - Fax:864-653-6618
Practice Address - Street 1:518 - 200 COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1430
Practice Address - Country:US
Practice Address - Phone:864-654-7980
Practice Address - Fax:864-653-6618
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0410152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCD04109Medicaid
SCD041095476Medicare ID - Type Unspecified
SCD04109Medicaid