Healthcare Provider Details

I. General information

NPI: 1316614241
Provider Name (Legal Business Name): ELDON EARL BELL M.D.,M.P.H
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3806 RIDGEMOOR DRIVE
RAPID CITY SD
57702-5327
US

IV. Provider business mailing address

3806 RIDGEMOOR DRIVE
RAPID CITY SD
57702-5327
US

V. Phone/Fax

Practice location:
  • Phone: 605-390-4502
  • Fax:
Mailing address:
  • Phone: 605-390-4502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0823
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0823
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number0823
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: