1013912286 PRIVIA MEDICAL GROUP INDIANA, LLC
Multi-Specialty Clinic/Center
Active
Basic Information
- Organization Name
- PRIVIA MEDICAL GROUP INDIANA, LLC
- Enumeration Date
- June 15, 2005
- Last Update
- April 17, 2025
- Authorized Official
- MR. THOMAS VANDERGRIFT
CHIEF EXECUTIVE ADMINISTRATOR
Phone: (574) 296-3200
Practice Location
- Address
- 303 S NAPPANEE ST
ELKHART, IN 465142066 - Phone
- (574) 296-3200
- Fax
- (574) 296-3392
Mailing Address
- Address
- PO BOX 778985
CHICAGO, IL 606778985 - Phone
- (574) 296-3200
- Fax
- (574) 296-3392
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Multi-Specialty Clinic/Center Multi-Specialty | 261QM1300X | Clinic/Center | N/A | IN | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0359310001 | 01 | IN | DMERC PTAN |
| 100466600A | 05 | IN | N/A |
Frequently Asked Questions
What is PRIVIA MEDICAL GROUP INDIANA, LLC's NPI number?
PRIVIA MEDICAL GROUP INDIANA, LLC's NPI number is 1013912286.
Which doctor has NPI number 1013912286?
The doctor with NPI number 1013912286 is PRIVIA MEDICAL GROUP INDIANA, LLC.
What is PRIVIA MEDICAL GROUP INDIANA, LLC's practice address?
PRIVIA MEDICAL GROUP INDIANA, LLC's practice address is 303 S NAPPANEE ST, ELKHART, IN, 465142066.
Which doctor practices at 303 S NAPPANEE ST, ELKHART, IN, 465142066?
PRIVIA MEDICAL GROUP INDIANA, LLC practices at 303 S NAPPANEE ST, ELKHART, IN, 465142066.
What is PRIVIA MEDICAL GROUP INDIANA, LLC's mailing address?
PRIVIA MEDICAL GROUP INDIANA, LLC's mailing address is PO BOX 778985, CHICAGO, IL, 606778985.
What is PRIVIA MEDICAL GROUP INDIANA, LLC's phone number?
PRIVIA MEDICAL GROUP INDIANA, LLC's phone number is (574) 296-3200.
Who is (574) 296-3200?
(574) 296-3200 is the phone number for PRIVIA MEDICAL GROUP INDIANA, LLC.
What is PRIVIA MEDICAL GROUP INDIANA, LLC's specialty?
PRIVIA MEDICAL GROUP INDIANA, LLC's specialty is Multi-Specialty Clinic/Center.
What type of doctor is PRIVIA MEDICAL GROUP INDIANA, LLC?
PRIVIA MEDICAL GROUP INDIANA, LLC is a Multi-Specialty Clinic/Center.
Is PRIVIA MEDICAL GROUP INDIANA, LLC a Multi-Specialty?
Yes, PRIVIA MEDICAL GROUP INDIANA, LLC is a Multi-Specialty.
Is PRIVIA MEDICAL GROUP INDIANA, LLC still practicing?
Yes, PRIVIA MEDICAL GROUP INDIANA, LLC is currently practicing.
Is PRIVIA MEDICAL GROUP INDIANA, LLC accepting new patients?
PRIVIA MEDICAL GROUP INDIANA, LLC may be accepting new patients. Please call their office at (574) 296-3200 to inquire about availability.
Is NPI 1013912286 still active?
Yes, NPI 1013912286 is currently active.
Where does PRIVIA MEDICAL GROUP INDIANA, LLC practice?
PRIVIA MEDICAL GROUP INDIANA, LLC practices in ELKHART, IN.