Provider Demographics
NPI:1417181413
Name:SPOT SERVICES PC
Entity Type:Organization
Organization Name:SPOT SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SPOT SERVICES PC
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-477-5000
Mailing Address - Street 1:5401 VOGEL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7832
Mailing Address - Country:US
Mailing Address - Phone:812-477-5000
Mailing Address - Fax:812-477-5002
Practice Address - Street 1:5401 VOGEL RD
Practice Address - Street 2:SUITE 140
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7832
Practice Address - Country:US
Practice Address - Phone:812-477-5000
Practice Address - Fax:812-477-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201364600AMedicaid
IN200940440AMedicaid