Organization
ATHENS MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA L DANIEL MBA (EX DIRECTOR)
(765) 364-5360
Entity
Organization
Contact information
Practice address
1660 LAFAYETTE RD, 100, CRAWFORDSVILLE, IN 47933-4601
(765) 359-1660
(765) 359-2233
Mailing address
1660 LAFAYETTE RD, 100, CRAWFORDSVILLE, IN 47933-4601
(765) 359-1660
(765) 359-2233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
08/21/2006
Last updated
10/25/2007
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