Provider Demographics
NPI:1932402971
Name:FLOYD MEMORIAL MEDICAL GROUP LLC
Entity type:Organization
Organization Name:FLOYD MEMORIAL MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-948-7632
Mailing Address - Street 1:727 MOUNT TABOR RD STE A
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-6951
Mailing Address - Country:US
Mailing Address - Phone:812-945-2717
Mailing Address - Fax:812-948-6572
Practice Address - Street 1:727 MOUNT TABOR RD STE A
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-6951
Practice Address - Country:US
Practice Address - Phone:812-945-2717
Practice Address - Fax:812-948-6572
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLOYD MEMORIAL HOSPITAL & HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty