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Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Bellefonte Primary and Pediatric Care
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
2028 WINCHESTER AVE, ASHLAND, KY 41101-7744
(606) 326-9001
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000598118
ANTHEM BCBS
KY
05
—
2913020
—
OH
05
—
7100062530
—
KY
05
—
7100115550
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
12/01/2008
Last updated
11/13/2018
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