MEDICARE: DR. JOSEPH PHILLIP SPOTT D.O.

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	207X00000X	Orthopaedic Surgery Physician	02001917A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
9	POO222849	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000373304	OTHER	IN	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	90001235	OTHER	IL	BCBS
5	N275934	OTHER	IN	HARMONY
6	7538064	OTHER	IN	AETNA
7	275934	OTHER	IN	WELLCARE
8	6582857	OTHER	IN	CIGNA

General Provider Information

NPI Number	:	1568437937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH PHILLIP SPOTT D.O.

Provider Business Mailing Address
First Line	:	9430 WICKER AVE
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-9768
Country	:	US
Telephone Number	:	219-558-8068
Fax Number	:	219-558-8149

Provider Business Practice Location Address
First Line	:	4320 FIR ST
Second Line	:	SUITE 417
City	:	EAST CHICAGO
State	:	IN
Zip	:	46312-3052
Country	:	US
Telephone Number	:	219-397-8648
Fax Number	:	219-397-8653

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	01/24/2017

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Directions to “ DR. JOSEPH PHILLIP SPOTT D.O.” Practice Location

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