Healthcare Provider Details

I. General information

NPI: 1275528309
Provider Name (Legal Business Name): JASON M. BELL D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CENTURIAN DRIVE SUITE 101
NEWARK DE
19713-2137
US

IV. Provider business mailing address

1 CENTURIAN DRIVE SUITE 101
NEWARK DE
19713-2137
US

V. Phone/Fax

Practice location:
  • Phone: 302-994-5275
  • Fax: 302-994-1794
Mailing address:
  • Phone: 302-994-5275
  • Fax: 302-994-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberEI0000152
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: