Organization
MARSHALL COUNTY MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARSHA TUCKER (OFFICE MANAGER)
(270) 527-2273
Entity
Organization
Contact information
Practice address
145 VINE STREET, BENTON, KY 42025
(270) 527-2273
Mailing address
PO BOX 569, BENTON, KY 42025-0569
(270) 527-2273
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30462
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6592143900
—
KY
Enumeration date
01/17/2007
Last updated
08/22/2020
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