Provider Demographics
NPI:1184133555
Name:HORIZON MEDICAL GROUP, INC
Entity type:Organization
Organization Name:HORIZON MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-446-5200
Mailing Address - Street 1:1345 UNITY PL STE 345
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-5761
Mailing Address - Country:US
Mailing Address - Phone:765-446-5200
Mailing Address - Fax:765-838-0972
Practice Address - Street 1:1345 UNITY PL STE 345
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5761
Practice Address - Country:US
Practice Address - Phone:765-446-5200
Practice Address - Fax:765-838-0972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty