Organization
BELLEFONTE PHYSICIAN SERVICES, INC
Active
Other names
Bellefonte Family Medicine Associates
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
903 BELLEFONTE RD, STE. B, FLATWOODS, KY 41139-2005
(606) 836-0165
(606) 836-0278
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000606034
ANTHEM BCBS
KY
05
—
7100071320
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
10/16/2008
Last updated
05/17/2019
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