Healthcare Provider Details

I. General information

NPI: 1164470720
Provider Name (Legal Business Name): WILLIAM J BELL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL ST
BOONEVILLE MS
38829
US

IV. Provider business mailing address

P O BOX 1729
HATTIESBURG MS
39403-1729
US

V. Phone/Fax

Practice location:
  • Phone: 800-291-4020
  • Fax: 919-419-7247
Mailing address:
  • Phone: 601-545-8700
  • Fax: 601-450-2493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number15015
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15015
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: