Bryan Wesley Bell
Individual provider Active NPI Pharmacist · Shattuck, OK
NPI 1306078613 · NPPES record last updated Aug 20, 2009
Key facts
- NPI
- 1306078613
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 14467 (OK)
- Practice address
- 522 S Main St
Shattuck, OK 73858-9604 - Phone
- (580) 938-2854
- Fax
- (580) 938-2888
- NPI assigned
- Aug 20, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14467 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laverne Pharmacy Management Inc | Current | Accepting new patients | |
| Shattuck Pharmacy Management Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14467 | OK | Yes |
Addresses
Primary practice location
522 S Main St
Shattuck, OK 73858-9604
Mailing address
P.O. Box 99
Shattuck, OK 73858-9604
Phone (580) 938-2854
Other providers in Shattuck, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.