MEDICARE: HEALTHSPOT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	01029905	IN

General Provider Information

NPI Number	:	1063489805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHSPOT

Provider Business Mailing Address
First Line	:	PO BOX 5235
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47407-5235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3064 E 3RD ST
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401-5425
Country	:	US
Telephone Number	:	812-323-9800
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JOHN IRVING CRONKHITE
Credential	:
Telephone Number	:	812-323-9800

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	08/22/2020

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Directions to “HEALTHSPOT ” Practice Location

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