Provider Demographics
NPI:1730119546
Name:TIMOTHY E BELL, D.O. PA
Entity Type:Organization
Organization Name:TIMOTHY E BELL, D.O. PA
Other - Org Name:KINGSTON HEALTH ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:865-717-1121
Mailing Address - Street 1:814 N KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-2678
Mailing Address - Country:US
Mailing Address - Phone:865-717-1121
Mailing Address - Fax:865-717-1167
Practice Address - Street 1:814 N KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2678
Practice Address - Country:US
Practice Address - Phone:865-717-1121
Practice Address - Fax:865-717-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3734289Medicaid
TN3734289Medicaid