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Organization

FMMG LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL J EICHENBERGER MD (PRESIDENT / CEO)
(812) 542-4921
Entity
Organization

Contact information

Practice address
1850 STATE ST, NEW ALBANY, IN 47150-4990
(812) 542-4906
(812) 949-5966
Mailing address
800 HIGHLANDER POINT DR STE 204, FLOYDS KNOBS, IN 47119-9465
(812) 542-4906
(812) 948-6715

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207XS0117X
Orthopaedic Surgery of the Spine Physician
2084P0800X
Psychiatry Physician
208600000X
Surgery Physician
208M00000X
Hospitalist Physician
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000729479
ANTHEM
IN
01
127750
SIHO
IN
05
201039920A
IN
05
201207730
IN
01
3361514
UNITED
IN
05
7100200500
KY
01
8891986
PHCS/MULTIPLAN
IN
01
9213755
AETNA
IN
01
9213755
AETNA
KY
01
DS6609
RR MEDICARE
IN
Enumeration date
07/21/2011
Last updated
07/08/2019
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