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Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Bellefonte Cosmetic and Reconstructive Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
1000 ASHLAND DR, STE. 303, ASHLAND, KY 41101-7084
(606) 325-0753
(606) 325-0757
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 325-0753
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000568862
ANTHEM BCBS
KY
05
—
2873270
—
OH
05
—
7100051130
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
05/29/2008
Last updated
11/13/2018
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