Healthcare Provider Details

I. General information

NPI: 1376538728
Provider Name (Legal Business Name): VICTOR CHARLES BELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COWLES ST FAIRBANKS MEMORIAL HOSPITAL
FAIRBANKS AK
99701-5925
US

IV. Provider business mailing address

PO BOX 55457
NORTH POLE AK
99705-0457
US

V. Phone/Fax

Practice location:
  • Phone: 907-458-5525
  • Fax: 907-458-5514
Mailing address:
  • Phone: 907-490-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD17167
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5273
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: