Provider Demographics
NPI:1972967149
Name:ACCUDOC INC PC
Entity Type:Organization
Organization Name:ACCUDOC INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-932-3224
Mailing Address - Street 1:1463 W WESTRIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47240-3252
Mailing Address - Country:US
Mailing Address - Phone:812-662-9500
Mailing Address - Fax:812-663-6102
Practice Address - Street 1:1463 W WESTRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:IN
Practice Address - Zip Code:47240-3252
Practice Address - Country:US
Practice Address - Phone:812-662-9500
Practice Address - Fax:812-663-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty