Organization
WESTLAKE PRIMARY CARE OF RUSSELL COUNTY MEDICAL GROUP
Active
Parent organization
ADAIR COUNTY HOSPITAL DISTRICT
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADAIR COUNTY HOSPITAL DISTRICT
Authorized official
MR. REX A TUNGATE CEO (CEO, ADMINISTRATOR)
(270) 384-4753
Entity
Organization
Contact information
Practice address
2465 LAKEWAY DRIVE, RUSSELL SPRINGS, KY 42642
(270) 858-3636
(270) 858-3660
Mailing address
2465 LAKEWAY DRIVE, RUSSELL SPRINGS, KY 42642
(270) 858-3636
(270) 858-3660
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
28235
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6592976200
—
KY
Enumeration date
03/25/2008
Last updated
03/25/2008
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