Individual
MR. JACK S BELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1411 W 4TH, SUITE G, COFFEYVILLE, KS 67337
(620) 251-5400
(620) 251-5412
Mailing address
226 SE DEBELL, BLDG A, BARTTESVILLE, OK 74006
(620) 251-5400
(620) 251-5412
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00239
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200334070A
—
KS
Enumeration date
09/25/2006
Last updated
06/14/2011
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