Provider Demographics
NPI:1891771465
Name:BELL, DAVID D (DPM)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:D
Last Name:BELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 932
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84091-0932
Mailing Address - Country:US
Mailing Address - Phone:801-619-2175
Mailing Address - Fax:801-553-9562
Practice Address - Street 1:1219 N 400 E
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7556
Practice Address - Country:US
Practice Address - Phone:435-753-7000
Practice Address - Fax:435-752-3856
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT104364-0501213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3836760001Medicare NSC
UT000002129Medicare PIN
UTT48841Medicare UPIN