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General NPI Number Information
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NPI Number | 1528119781
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Entity Type | Organization
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Legal Business Name | SOUTHSIDE ENDOCRINOLOGY LLC
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 08/31/2016
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Provider Practice Location Address
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Address Line | 1900 CRESTWOOD BLVD STE 201
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City | IRONDALE
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State | AL
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Zip | 35210-2051
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Country | US
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Telephone | 205-957-0034
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Fax | 205-957-0036
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Provider Business Mailing Address
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Address Line | 1900 CRESTWOOD BLVD STE 201
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City | IRONDALE
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State | AL
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Zip | 35210-2051
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Country | US
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Telephone | 205-957-0034
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Fax | 205-957-0036
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID SAMUEL HENRY BELL
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Credential | M.D.
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Telephone | 205-957-0034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 9301
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License Number State | AL
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