Provider Demographics
NPI:1336789031
Name:SPURGEON, DON (OTR)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:
Last Name:SPURGEON
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 BUTTERNUT CIR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-7811
Mailing Address - Country:US
Mailing Address - Phone:317-448-0417
Mailing Address - Fax:
Practice Address - Street 1:250 SHENANDOAH DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5927
Practice Address - Country:US
Practice Address - Phone:765-234-8790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31004744A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist