Organization
MARSHALL COUNTY HOSPITAL DISTRICT
Active
Other names
Marshall Co Surgical & Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE KELLEY (CFO)
(270) 527-4852
Entity
Organization
Contact information
Practice address
619 OLD SYMSONIA RD, BENTON, KY 42025-5094
(270) 527-2411
(270) 527-8734
Mailing address
619 OLD SYMSONIA RD, BENTON, KY 42025-5094
(270) 527-2411
(270) 527-8734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
24262
KY
207Q00000X
Family Medicine Physician
Primary
TP638
KY
207R00000X
Internal Medicine Physician
17956
KY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
21862
KY
207X00000X
Orthopaedic Surgery Physician
24325
KY
261QU0200X
Urgent Care Clinic/Center
—
—
363AM0700X
Medical Physician Assistant
PA540
KY
363LF0000X
Family Nurse Practitioner
2422P
KY
367500000X
Certified Registered Nurse Anesthetist
034466
KY
367500000X
Certified Registered Nurse Anesthetist
1026012
KY
367500000X
Certified Registered Nurse Anesthetist
1027758
KY
367500000X
Certified Registered Nurse Anesthetist
1559A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054610
BLUE CROSS
KY
01
—
000000057043
BLUE CROSS AND BLUE SHIEL
KY
05
—
01015338
—
KY
01
—
110104797
RR MEDICARE
—
05
—
65912362
—
KY
05
—
78905304
—
KY
01
—
DF7240
RR MEDICARE
KY
Enumeration date
09/12/2006
Last updated
04/14/2026
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