Provider Demographics
NPI:1073061701
Name:HARCOURT, ERIC
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HARCOURT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47722-1000
Mailing Address - Country:US
Mailing Address - Phone:812-488-3702
Mailing Address - Fax:
Practice Address - Street 1:1800 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47722-1000
Practice Address - Country:US
Practice Address - Phone:812-488-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36003161A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer