Organization
FMMG HARRISON FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL EICHENBERGER (PRESIDENT / CEO)
(812) 948-7632
Entity
Organization
Contact information
Practice address
313 FEDERAL DR NW, SUITE 200, CORYDON, IN 47112-3070
(812) 738-4155
(812) 738-6104
Mailing address
313 FEDERAL DR NW, SUITE 200, CORYDON, IN 47112-3070
(812) 738-4155
(812) 738-6104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201040630
—
IN
Enumeration date
06/01/2011
Last updated
05/26/2016
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