Provider Demographics
NPI:1972686772
Name:BELLI, MARTIN F (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:F
Last Name:BELLI
Suffix:
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:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-0173
Mailing Address - Country:US
Mailing Address - Phone:325-646-7899
Mailing Address - Fax:325-646-7768
Practice Address - Street 1:120 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5918
Practice Address - Country:US
Practice Address - Phone:325-646-7899
Practice Address - Fax:325-646-7768
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7429207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099895704Medicaid
TX8A6292Medicare ID - Type Unspecified
TX099895704Medicaid