| Casey County Primary Medical Group | |
|
187 Wolford Ave Liberty KY 42539-3278 | |
| (606) 787-6275 | |
| Not Available |
| Full Name | Casey County Primary Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 187 Wolford Ave, Liberty, Kentucky |
| Authorized Official Name and Position | Rex A Tungate (CEO) |
| Authorized Official Contact | 2703844753 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Casey County Primary Medical Group 187 Wolford Ave Liberty KY 42539-3278 Ph: (606) 787-6275 | Casey County Primary Medical Group 187 Wolford Ave Liberty KY 42539-3278 Ph: (606) 787-6275 |
| NPI Number | 1588837223 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 04/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588837223 | NPI | - | NPPES |
| 6590989700 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 900075 (Kentucky) | Primary |
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