Provider Demographics
NPI:1679586697
Name:BELL, DELORIS WILEY (MD)
Entity type:Individual
Prefix:
First Name:DELORIS
Middle Name:WILEY
Last Name:BELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:D
Other - Middle Name:W
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7000 W 121ST ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2008
Mailing Address - Country:US
Mailing Address - Phone:913-498-2015
Mailing Address - Fax:913-469-0176
Practice Address - Street 1:7000 W 121ST ST
Practice Address - Street 2:STE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2008
Practice Address - Country:US
Practice Address - Phone:913-498-2015
Practice Address - Fax:913-469-0176
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-14180207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS401838OtherBLUE SHIELD KANSAS
KS03143017OtherBLUE CROSS BLUE SHIELD
KSI252693Medicare PIN