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Organization

PRIVIA MEDICAL GROUP INDIANA, LLC

Active
Other names
Elkhart Family Physicians
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEVIN R BOYER (CHIEF EXECUTIVE ADMINISTRATOR)
(574) 296-3200
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
04/06/2009
Last updated
05/12/2025
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