NPI 1013380526

Privia Medical Group Indiana, LLC

Organisation Ophthalmology Physician Elkhart, IN

Practice location

Address: 2222 W Lexington Ave, Elkhart, IN 46514-1420
Phone: (574) 294-3030
Fax: (574) 296-3544
Mailing address: PO Box 2968, Elkhart, IN 46515-2968

Authorised official

Name: Thomas Vandergrift
Title: Ceo
Phone: (574) 296-3200

Registered specialties

Ophthalmology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207W00000X

Other Ophthalmology providers in Indiana →

Registry record

NPI: 1013380526
Entity type: Organization
NPI issued: 5 Nov 2015
Record last updated: 12 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.