Organization
ADAIR COUNTY HOSPITAL DISTRICT
Active
Parent organization
EDMONTON PRIMARY CARE
Other names
Edmonton Primary Care Med Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDMONTON PRIMARY CARE
Authorized official
REX A TUNGATE (CEO)
(270) 384-4753
Entity
Organization
Contact information
Practice address
903 WEST STOCKTON STREET, EDMONTON, KY 42129
(270) 384-4753
Mailing address
903 WEST STOCKTON STREET, EDMONTON, KY 42129
(270) 384-4753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
900028
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6590990500
—
KY
Enumeration date
03/31/2008
Last updated
03/31/2008
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