Organization
FAMILY MEDICAL C ENTER OF HART COUNTY
Active
Parent organization
FAMILY MEDICAL CENTER OF HART COUNTY
Other names
Family Medical Center of Hart County Non-RHC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY MEDICAL CENTER OF HART COUNTY
Authorized official
MR. JAMES WALLACE MIDDLETON M.D. (MEDICAL DIRECTOR)
(270) 524-7231
Entity
Organization
Contact information
Practice address
205 WASHINGTON ST, MUNFORDVILLE, KY 42765-8900
(270) 524-7800
Mailing address
PO BOX 579, MUNFORDVILLE, KY 42765-0579
(270) 524-7231
(270) 524-7415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000057825
ANTHEM
KY
01
—
1064127
PASSPORT-SPECIALTIST GROUP
KY
01
—
1064168
PASSPORT
—
05
—
65904476
—
KY
01
—
7100120170
MEDICAID- PHYSICAL THERAPY GROUP
KY
01
—
7100197650
MEDICAID- PHYSICIAN OFFICE
KY
01
—
CF7880
RAILROAD MEDICARE
—
01
—
K007193
CHAMPUS-TRICARE
—
Enumeration date
12/27/2007
Last updated
01/29/2021
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