Organization
BELLEFONTE PHYSICIAN SERVICES, INC.
Active
Other names
Bellefonte Urological Associates
Organization subpart
No
Provider details
NPI number
Authorized official
TROY CONNETT (DIRECTOR OF FINANCE)
(606) 833-3333
Entity
Organization
Contact information
Practice address
1000 ASHLAND DR, STE. 302, ASHLAND, KY 41101-7084
(606) 833-6235
(606) 833-4668
Mailing address
PO BOX 2155, ASHLAND, KY 41105-2155
(606) 833-4922
(606) 833-4668
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000665198
ANTHEM BCBS
KY
05
—
3059354
—
OH
05
—
7100122770
—
KY
05
—
7100159670
—
KY
01
—
DN8303
RR MEDICARE
KY
Enumeration date
03/31/2010
Last updated
05/20/2019
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