Healthcare Provider Details

I. General information

NPI: 1720029564
Provider Name (Legal Business Name): CLARENCE A BELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 04/08/2020
Certification Date: 04/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 EAST SNYDER AVENUE
MONTPELIER OH
43543-1271
US

IV. Provider business mailing address

433 W HIGH ST
BRYAN OH
43506-1690
US

V. Phone/Fax

Practice location:
  • Phone: 419-485-3154
  • Fax: 419-485-3833
Mailing address:
  • Phone: 419-636-1131
  • Fax: 419-636-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35042155
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: