Provider Demographics
NPI:1730277971
Name:BELL, JOHN D (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:BELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 HIGH POND ROAD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:VT
Mailing Address - Zip Code:05733
Mailing Address - Country:US
Mailing Address - Phone:802-247-4448
Mailing Address - Fax:
Practice Address - Street 1:401 DIAMOND RUN MALL
Practice Address - Street 2:LENSCRAFTERS
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701
Practice Address - Country:US
Practice Address - Phone:802-775-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT030-0000235152W00000X
NYT005921-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTU69576Medicare UPIN