MEDICARE: AMY ELIZABETH BELL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4901005596	MI

General Provider Information

NPI Number	:	1639818263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ELIZABETH BELL O.D.

Provider Business Mailing Address
First Line	:	HIEMSTRA OPTICAL CO
Second Line	:	255 ROMENCE RD
City	:	PORTAGE
State	:	MI
Zip	:	49024
Country	:	US
Telephone Number	:	269-324-0800
Fax Number	:	269-324-0894

Provider Business Practice Location Address
First Line	:	3890 CHARLEVOIX RD STE 270
Second Line	:
City	:	PETOSKEY
State	:	MI
Zip	:	49770-8423
Country	:	US
Telephone Number	:	231-439-3937
Fax Number	:	231-439-9058

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2022
Last Update Date	:	03/27/2025

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