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Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Bellefonte Primary Care, Grayson
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
100 BELLEFONTE DR, GRAYSON, KY 41143-1820
(606) 474-0669
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(877) 214-4267
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000609053
ANTHEM BCBS
KY
05
—
2933295
—
OH
01
—
7071800
AETNA
KY
05
—
7100068100
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
01/02/2009
Last updated
05/20/2019
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