# GRAND OLD DOCS OF THE SOUTHSIDE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Central Indiana Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942396890
- **Authorized official:** DONALD E DUGGAN MD (PHYSICIAN)
- **Authorized official phone:** (317) 882-7344

## Contact information

- **Practice address:** 134 N EMERSON AVE, GREENWOOD, IN 46143-9760
- **Practice address phone:** (317) 882-7344
- **Practice address fax:** (317) 882-4793
- **Mailing address:** 1350 E COUNTY LINE RD, SUITE I, INDIANAPOLIS, IN 46227-0873
- **Mailing address phone:** (317) 882-7344
- **Mailing address fax:** (317) 882-4793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 09/10/2008