Healthcare Provider Details

I. General information

NPI: 1992031827
Provider Name (Legal Business Name): BRUCE R. KING BELL, OD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2009
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 HUNTER ST
ROCKMART GA
30153-1916
US

IV. Provider business mailing address

530 HUNTER ST
ROCKMART GA
30153-1916
US

V. Phone/Fax

Practice location:
  • Phone: 770-684-5650
  • Fax: 770-684-1539
Mailing address:
  • Phone: 770-684-5650
  • Fax: 770-684-1539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT000877
License Number StateGA

VIII. Authorized Official

Name: DR. BRUCE K BELL
Title or Position: PRESIDENT
Credential: O.D.
Phone: 770-684-5650