Provider Demographics
NPI:1518960855
Name:BELLO, CLAIR L III (DPM)
Entity Type:Individual
Prefix:DR
First Name:CLAIR
Middle Name:L
Last Name:BELLO
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:106 STUART RD
Mailing Address - Street 2:MY FOOT DOCTOR PLLC
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312
Mailing Address - Country:US
Mailing Address - Phone:423-559-9700
Mailing Address - Fax:423-472-7782
Practice Address - Street 1:705 COOK DR. SUITE 200
Practice Address - Street 2:MY FOOT DOCTOR PLLC
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303
Practice Address - Country:US
Practice Address - Phone:423-744-9399
Practice Address - Fax:423-744-3067
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2018-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAPOD001010213ES0103X
TNDPM0000000637213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3354074Medicaid
U99334Medicare UPIN