Provider Demographics
NPI:1578508453
Name:VANDERBURGH COUNTY
Entity Type:Organization
Organization Name:VANDERBURGH COUNTY
Other - Org Name:VANDERBURGH COUNTY DEPARTMENT OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:SPEAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:812-435-5443
Mailing Address - Street 1:420 MULBERRY ST
Mailing Address - Street 2:OAK PARK PROFESSIONAL BUILDING
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1231
Mailing Address - Country:US
Mailing Address - Phone:812-435-5443
Mailing Address - Fax:812-435-5468
Practice Address - Street 1:420 MULBERRY ST
Practice Address - Street 2:OAK PARK PROFESSIONAL BUILDING
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1231
Practice Address - Country:US
Practice Address - Phone:812-435-5443
Practice Address - Fax:812-435-5468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100322900Medicaid
IN100241710AMedicaid
IN232510Medicare PIN