SYRACUSE FAMILY PRACTICE LLC NPI 1770613879

NPI Information

  • NPI: 1770613879
  • Provider Name: SYRACUSE FAMILY PRACTICE, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 15D0356972
  • Address: 1033 N INDIANA AVE
    SYRACUSE, IN
    ZIP 46567
  • Phone: (574) 457-5701

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NPI Details

SYRACUSE FAMILY PRACTICE, LLC is a family medicine in Syracuse, IN. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SYRACUSE FAMILY PRACTICE, LLC NPI is 1770613879. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1033 N INDIANA AVE
SYRACUSE, IN
ZIP 46567-017
Phone: (574) 457-5701
Fax: (574) 457-5609

The provider's authorized official is Larry D Allen .
The authorized official title is Owner and has the following contact phone number (574) 457-5701.

The CLIA number assigned to this NPI record is 15D0356972 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/7/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 11/21/2025

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