# CASEY COUNTY HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CASEY CO HOSPITAL DISTRICT
- **Other names:** CASEY COUNTY HOSPITAL MEDICAL GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649454067
- **Legal business name:** CASEY CO HOSPITAL DISTRICT
- **Authorized official:** MR. REX A TUNGATE (CEO)
- **Authorized official phone:** (606) 787-6275

## Contact information

- **Practice address:** 187 WOLFORD AVE, LIBERTY, KY 42539-3278
- **Practice address phone:** (606) 787-6275
- **Practice address fax:** (606) 787-9717
- **Mailing address:** 187 WOLFORD AVE, LIBERTY, KY 42539-3278
- **Mailing address phone:** (606) 787-6275
- **Mailing address fax:** (606) 787-9717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 31531 | KY | Yes |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | 28235 | KY | — |

## Other

- **Enumeration date:** 12/20/2007
- **Last updated:** 11/03/2017