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Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Ashland Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
2222 WINCHESTER AVE, ASHLAND, KY 41101-7847
(606) 325-9644
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000578807
ANTHEM BCBS
KY
05
—
7100049600
—
KY
05
—
7100442070
—
KY
Enumeration date
11/24/2008
Last updated
05/17/2019
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