# PRIVIA MEDICAL GROUP INDIANA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elkhart Family Physicians
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982846010
- **Authorized official:** MR. KEVIN R BOYER (CHIEF EXECUTIVE ADMINISTRATOR)
- **Authorized official phone:** (574) 296-3200

## Contact information

- **Practice address:** 2115 W LEXINGTON AVE, ELKHART, IN 46514-1423
- **Practice address phone:** (574) 296-3955
- **Practice address fax:** (574) 296-3999
- **Mailing address:** 303 S NAPPANEE ST, ELKHART, IN 46514-2066
- **Mailing address phone:** (574) 296-3200
- **Mailing address fax:** (574) 296-3392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/06/2009
- **Last updated:** 05/12/2025