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Organization
BELLEFONTE PHYSICIAN SERVICES, INC
Active
Organization
BELLEFONTE PHYSICIAN SERVICES, INC
Active
Other names
Bellefonte Family Medicine Associates
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
903 BELLEFONTE RD, STE. B, FLATWOODS, KY 41139-2005
(606) 836-0165
(606) 836-0278
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000606034
ANTHEM BCBS
KY
05
—
7100071320
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
10/16/2008
Last updated
05/17/2019
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