Individual
ROBERT J BELISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8780 US HIGHWAY 42, SUITE A, FLORENCE, KY 41042-8850
(859) 384-2660
(859) 384-5248
Mailing address
2300 CHAMBER CENTER DR, SUITE 200, LAKESIDE PARK, KY 41017-1673
(859) 344-5555
(859) 384-5248
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02651
KY
207Q00000X
Family Medicine Physician
34002859B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02651
MEDICAL LICENSE
KY
05
—
0426515
—
OH
01
—
34.002859
MEDICAL LICENSE
OH
05
—
64122195
—
KY
01
—
P00344889
RAILROAD MEDICARE
KY
Enumeration date
07/01/2005
Last updated
06/25/2014
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