Organization
BELLEFONTE PHYSICIAN SERVICES
Active
Other names
Bellefonte Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
1101 SAINT CHRISTOPHER DR STE 320, ASHLAND, KY 41101-7000
(606) 833-0311
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-3333
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000589168
ANTHEM BCBS
KY
05
—
7100063170
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
07/23/2008
Last updated
11/12/2018
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