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Organization

FAMILY MEDICAL CENTER OF HART CO

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES W MIDDLETON JR. MD (PRESIDENT)
(270) 524-7231
Entity
Organization

Contact information

Practice address
117 W SOUTH ST, MUNFORDVILLE, KY 42765
(270) 524-7231
(270) 524-7415
Mailing address
PO BOX 579, MUNFORDVILLE, KY 42765
(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
261QR1300X
Rural Health Clinic/Center
Primary
900144
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000057825
ANTHEM GROUP
KY
01
1064168
PASSPORT MEDICAID MGD CAR
KY
05
35001346
KY
01
4674
OLD ANTHEM GROUP
KY
05
7100157220
KY
01
CF7880
RAILROAD MEDICARE UNITED
KY
01
K007193
CHAMPUS TRICARE GROUP
KY
Enumeration date
04/20/2006
Last updated
01/29/2021
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