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Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Bellefonte Urological Associates
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. 302, ASHLAND, KY 41101-7084
(606) 833-6235
(606) 833-4668
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4922
(606) 833-4668
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000665198
ANTHEM BCBS
KY
05
—
3059354
—
OH
05
—
7100122770
—
KY
05
—
7100159670
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
03/31/2010
Last updated
05/20/2019
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