Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Bellefonte Primary and Pediatric Care
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
2028 WINCHESTER AVE, ASHLAND, KY 41101-7744
(606) 326-9001
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4680
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000598118
ANTHEM BCBS
KY
05
—
2913020
—
OH
05
—
7100062530
—
KY
05
—
7100115550
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
12/01/2008
Last updated
11/13/2018
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