MEDICARE: PHYSICIAN ASSOCIATES OF FLOYDS KNOBS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568503811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN ASSOCIATES OF FLOYDS KNOBS, LLC

Provider Business Mailing Address
First Line	:	800 HIGHLANDER POINT DR
Second Line	:	SUITE 300
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119-9465
Country	:	US
Telephone Number	:	812-923-2273
Fax Number	:	812-923-4100

Provider Business Practice Location Address
First Line	:	800 HIGHLANDER POINT DR
Second Line	:	SUITE 300
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119-9465
Country	:	US
Telephone Number	:	812-923-2273
Fax Number	:	812-923-4100

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL J EICHENBERGER
Credential	:	M.D.
Telephone Number	:	812-923-2273

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	11/16/2009

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Directions to “PHYSICIAN ASSOCIATES OF FLOYDS KNOBS, LLC ” Practice Location

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