Healthcare Provider Details

I. General information

NPI: 1962085084
Provider Name (Legal Business Name): MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 09/10/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S 8TH ST STE 203E
MURRAY KY
42071-2400
US

IV. Provider business mailing address

300 S 8TH ST STE 203E
MURRAY KY
42071-2400
US

V. Phone/Fax

Practice location:
  • Phone: 270-762-1562
  • Fax: 270-767-3633
Mailing address:
  • Phone: 270-762-1562
  • Fax: 270-767-3633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: JOHN BRADFORD
Title or Position: OFFICER/CFO
Credential:
Phone: 270-762-1100