Healthcare Provider Details

I. General information

NPI: 1609826080
Provider Name (Legal Business Name): BART G BELLAMY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 VILLAGE DR SUITE 130
LINCOLN NE
68516-6619
US

IV. Provider business mailing address

6041 VILLAGE DR SUITE 130
LINCOLN NE
68516-6619
US

V. Phone/Fax

Practice location:
  • Phone: 402-423-1382
  • Fax: 402-423-3590
Mailing address:
  • Phone: 402-423-1382
  • Fax: 402-423-3590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number356
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: