Bellefonte Physician Services, Inc.

Organization Active NPI Pediatrics Physician · Russell, KY

NPI 1780930560 · NPPES record last updated Nov 13, 2018

Key facts

NPI
1780930560
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
BELLEFONTE PHYSICIAN SERVICES, INC.
Practice address
1061 Kenwood Dr
Russell, KY 41169-1527
Phone
(606) 833-6750
NPI assigned
Jul 30, 2012
Organization subpart
No

Authorized official

Name
Troy Connett
Title
Director of Finance
Phone
(606) 833-3333

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X Yes
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

1061 Kenwood Dr
Russell, KY 41169-1527

Mailing address

PO Box 2155
Ashland, KY 41105-2155
Phone (606) 833-4922

Other identifiers

IdentifierTypeStateIssuer
7100222090MedicaidKY

Other names

  • Bellefonte Pediatrics Russell Doing business as

Other providers in Russell, KY

All providers in Russell, KY · Pediatrics Physician in Kentucky

Sources for this page

Verify at the official NPI Registry.