Basic Information
| Provider Information | |||||||||
| NPI: | 1174628374 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2502 S ASHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | GREEN BAY | ||||||||
| State: | WI | ||||||||
| PostalCode: | 543045252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9204964700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3055 HUBERTUS RD | ||||||||
| Address2: | |||||||||
| City: | HUBERTUS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530339316 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2626289000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 06/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036-100708 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 64875 | WI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.