Healthcare Provider Details

I. General information

NPI: 1447676937
Provider Name (Legal Business Name): CHRISTOPHER BELLAMY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2014
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 E JOHNSON AVE
JONESBORO AR
72401-8413
US

IV. Provider business mailing address

PO BOX 1960
JONESBORO AR
72403-1960
US

V. Phone/Fax

Practice location:
  • Phone: 870-936-8000
  • Fax: 870-934-3631
Mailing address:
  • Phone: 870-936-8000
  • Fax: 870-934-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberE-10990
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: