Healthcare Provider Details

I. General information

NPI: 1801069588
Provider Name (Legal Business Name): CRITTENDEN COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 WEST GUM ST
MARION KY
42064-0386
US

IV. Provider business mailing address

PO BOX 386
MARION KY
42064-0386
US

V. Phone/Fax

Practice location:
  • Phone: 270-965-1042
  • Fax: 270-965-1061
Mailing address:
  • Phone: 270-965-1042
  • Fax: 270-965-1061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MISTY KAY MCKINNEY
Title or Position: CONTROLLER
Credential:
Phone: 270-965-1001