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General NPI Number Information
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NPI Number | 1649618778
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Entity Type | Organization
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Legal Business Name | BELLEFONTE PHYSICIAN SERVICES, INC.
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 11/12/2018
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Provider Practice Location Address
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Address Line | 1629 ASHLAND RD
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City | GREENUP
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State | KY
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Zip | 41144
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Country | US
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Telephone | 606-833-3333
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2155
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City | ASHLAND
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State | KY
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Zip | 41105-2155
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Country | US
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Telephone | 606-833-4922
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF FINANCE
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Name | TROY CONNETT
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Credential |
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Telephone | 606-833-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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