Provider Demographics
NPI:1811318066
Name:BELL, JAMES ROBERT
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT
Last Name:BELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 OAK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-1617
Mailing Address - Country:US
Mailing Address - Phone:580-832-3807
Mailing Address - Fax:580-327-2223
Practice Address - Street 1:411 OAK CREEK DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-1617
Practice Address - Country:US
Practice Address - Phone:580-832-3807
Practice Address - Fax:580-327-2223
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK178530174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist