# ATHENS MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831205210
- **Authorized official:** TERESA L DANIEL MBA (EX DIRECTOR)
- **Authorized official phone:** (765) 364-5360

## Contact information

- **Practice address:** 1660 LAFAYETTE RD, 100, CRAWFORDSVILLE, IN 47933-4601
- **Practice address phone:** (765) 359-1660
- **Practice address fax:** (765) 359-2233
- **Mailing address:** 1660 LAFAYETTE RD, 100, CRAWFORDSVILLE, IN 47933-4601
- **Mailing address phone:** (765) 359-1660
- **Mailing address fax:** (765) 359-2233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 207Y00000X | Otolaryngology Physician | — | NULL | — |
| 207Y00000X | Otolaryngology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 08/21/2006
- **Last updated:** 10/25/2007