Healthcare Provider Details

I. General information

NPI: 1942297007
Provider Name (Legal Business Name): BRADLEY B BELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL BLVD
JEFFERSONVILLE IN
47130-3748
US

IV. Provider business mailing address

101 HOSPITAL BLVD
JEFFERSONVILLE IN
47130-3748
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-3899
  • Fax: 812-282-4173
Mailing address:
  • Phone: 812-282-3899
  • Fax: 812-282-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number01044030A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35150
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: