# FLORA FAMILY MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629499330
- **Authorized official:** JASON L DUTTER MD (PHYSICIAN)
- **Authorized official phone:** (765) 446-5417

## Contact information

- **Practice address:** 4 E MAIN ST, FLORA, IN 46929-1351
- **Practice address phone:** (574) 967-4523
- **Practice address fax:** (765) 446-5317
- **Mailing address:** PO BOX 4699, LAFAYETTE, IN 47903-4699
- **Mailing address phone:** (765) 449-2732
- **Mailing address fax:** (765) 449-1196

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01056529A | IN | Yes |

## Other

- **Enumeration date:** 12/23/2013
- **Last updated:** 01/14/2014