Basic Information
| Provider Information | |||||||||
| NPI: | 1063614998 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BELL | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 929 N SAINT FRANCIS ST | ||||||||
| Address2: | EMERGENCY DEPARTMENT VIA CHRISTI HOSPITAL | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672143821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162685775 | ||||||||
| FaxNumber: | 3162917496 | ||||||||
| Practice Location | |||||||||
| Address1: | 929 N SAINT FRANCIS ST | ||||||||
| Address2: | EMERGENCY DEPARTMENT VIA CHRISTI HOSPITAL | ||||||||
| City: | WICHITA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 672143821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3162685775 | ||||||||
| FaxNumber: | 3162917496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2007 | ||||||||
| LastUpdateDate: | 11/24/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | C7-0003763 | DE | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | C1-0009023 | DE | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 40038 | SC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 04-34497 | KS | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200654700A | 05 | KS | MEDICAID | 400383 | 05 | SC | MEDICAID | SC90299068 | 01 | SC | MEDICARE PIN | OTHER | SC90298510 | 01 | SC | MEDICARE PIN | OTHER |