Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Boardman Family Practice PLLC

Organization Family Medicine Physician · NPI 1740564681

Boardman Family Practice PLLC is a Family Medicine Physician in South Boardman, Michigan. Licensed in Michigan. Registered with an NPI since 2011.

Licensed in
MI
In the registry since
2011
Specialties on file
3
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4713 Pine St SW
South Boardman, MI 49680-9761
Phone: (231) 518-0189
Fax: (231) 518-0188
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X
Family Medicine Physician Taxonomy 207Q00000X · Licence 5101013379 (MI)
Physician Assistant Taxonomy 363A00000X · Licence 5601002729 (MI)

Record details

NPI number1740564681
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Todd Kreykes — Owner · (231) 624-1054
NPI enumeratedOctober 10, 2011
Last updated in NPPESMarch 30, 2016
Mailing address4713 Pine St Sw, South Boardman, MI 49680-9761

Other providers in South Boardman