Provider Demographics
NPI:1912052549
Name:BELL, OWEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:R
Last Name:BELL
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 1:2501 E 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5369
Mailing Address - Country:US
Mailing Address - Phone:907-561-1925
Mailing Address - Fax:907-561-1429
Practice Address - Street 1:2501 E 42ND AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5369
Practice Address - Country:US
Practice Address - Phone:907-561-1925
Practice Address - Fax:907-561-1429
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2189207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2189Medicaid
AK151128Medicare ID - Type UnspecifiedMEDICARE
AKMD2189Medicaid
E51233Medicare UPIN