# CASEY COUNTY HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CASEY COUNTY HOSPITAL DISTRICT
- **Other names:** Casey County Primary Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588837223
- **Legal business name:** CASEY COUNTY HOSPITAL DISTRICT
- **Authorized official:** REX A TUNGATE (CEO)
- **Authorized official phone:** (270) 384-4753

## Contact information

- **Practice address:** 187 WOLFORD AVE, LIBERTY, KY 42539-3278
- **Practice address phone:** (606) 787-6275
- **Mailing address:** 187 WOLFORD AVE, LIBERTY, KY 42539-3278
- **Mailing address phone:** (606) 787-6275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 900075 | KY | Yes |

## Other

- **Enumeration date:** 04/02/2008
- **Last updated:** 04/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6590989700 | — | KY |