Provider Demographics
NPI:1710975743
Name:BELL, RAYMOND LLOYD SR (MD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:LLOYD
Last Name:BELL
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2261 COSTARIDES ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36617-2443
Mailing Address - Country:US
Mailing Address - Phone:251-471-4402
Mailing Address - Fax:251-471-4496
Practice Address - Street 1:2261 COSTARIDES ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2443
Practice Address - Country:US
Practice Address - Phone:251-471-4402
Practice Address - Fax:251-471-4496
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-13
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL8377207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL847Medicaid
AL847Medicaid
AL000847Medicare ID - Type Unspecified