Healthcare Provider Details

I. General information

NPI: 1093791915
Provider Name (Legal Business Name): MARTIN COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 06/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 ROCKCASTLE ROAD
INEZ KY
41224
US

IV. Provider business mailing address

PO BOX 346 136 ROCKCASTLE ROAD
INEZ KY
41224-0346
US

V. Phone/Fax

Practice location:
  • Phone: 606-298-7752
  • Fax: 606-298-0413
Mailing address:
  • Phone: 606-298-7752
  • Fax: 606-298-0413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN WARD
Title or Position: PUBLIC HEALTH DIRECTOR
Credential:
Phone: 606-298-7752