Organization
BELLEFONTE PHYSICIAN SERVICES, INC
Active
Other names
Ironton Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
1005 E RING RD, STE. 2, IRONTON, OH 45638-9610
(740) 534-9830
(740) 534-9832
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4680
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
002901
OH
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000585216
ANTHEM BCBS
KY
05
—
2868026
—
OH
05
—
7100061740
—
KY
05
—
7100084940
—
KY
01
—
DO3581
RR MEDICARE
OH
Enumeration date
07/21/2008
Last updated
10/21/2019
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