MEDICARE: BELLS FAMILY MEDICINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner		TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4085780	OTHER	TN	BC/BS TENNCARE SELECT
3	0531133	OTHER	TN	UHAC
4	4085780	OTHER	TN	BC/BS OF TENNESSEE
5	32141	OTHER	TN	TLC -TN MANAGED CARE

General Provider Information

NPI Number	:	1538128640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLS FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	103 FRONT STREET
Second Line	:
City	:	BELLS
State	:	TN
Zip	:	38006
Country	:	US
Telephone Number	:	731-663-3794
Fax Number	:	731-663-3737

Provider Business Practice Location Address
First Line	:	103 FRONT ST
Second Line	:
City	:	BELLS
State	:	TN
Zip	:	38006
Country	:	US
Telephone Number	:	731-663-3794
Fax Number	:	731-663-3737

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. ALICE JEANETTE WALDROP
Credential	:	FNP
Telephone Number	:	731-663-3794

Provider Enumeration Date	:	03/20/2006
Last Update Date	:	08/22/2020

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Directions to “BELLS FAMILY MEDICINE ” Practice Location

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