Healthcare Provider Details

I. General information

NPI: 1720361892
Provider Name (Legal Business Name): CLINT BELL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2011
Last Update Date: 12/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5395 W ASH ST STE 9
POTTSVILLE AR
72858-9170
US

IV. Provider business mailing address

5395 W ASH ST STE 9
POTTSVILLE AR
72858-9170
US

V. Phone/Fax

Practice location:
  • Phone: 479-498-4130
  • Fax: 479-498-4133
Mailing address:
  • Phone: 479-498-4130
  • Fax: 479-498-4133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD10310
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: