Provider Demographics
NPI:1801874185
Name:BELL, BRYAN A (OD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:A
Last Name:BELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:13965 W BURLEIGH RD STE 108
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3074
Mailing Address - Country:US
Mailing Address - Phone:262-505-5440
Mailing Address - Fax:262-505-5414
Practice Address - Street 1:13965 W BURLEIGH RD STE 108
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-3074
Practice Address - Country:US
Practice Address - Phone:262-505-5440
Practice Address - Fax:262-505-5414
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI3010-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIV07694Medicare UPIN