Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Bellefonte Women's Care
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
2001 WINCHESTER AVE, ASHLAND, KY 41101-7743
(606) 324-7351
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4922
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
6081P
KY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000583780
ANTHEM BCBS
KY
05
—
2875296
—
OH
05
—
7100052850
—
KY
05
—
7100052870
—
KY
Enumeration date
11/11/2008
Last updated
11/13/2018
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