Healthcare Provider Details

I. General information

NPI: 1750596078
Provider Name (Legal Business Name): CARL HENDRICK BELL JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W 40TH AVE
PINE BLUFF AR
71603-6301
US

IV. Provider business mailing address

4436 DIVOKY RD
PINE BLUFF AR
71603-9508
US

V. Phone/Fax

Practice location:
  • Phone: 870-541-7100
  • Fax:
Mailing address:
  • Phone: 870-879-3364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC-4666
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: