Organization
SPINE & MUSCULOSKELETAL CENTER PC
Active
Other names
Superior Orthopedics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH P SPOTT DO (OWNER)
(219) 397-8648
Entity
Organization
Contact information
Practice address
2020 E COLUMBUS DRIVE, SUITE B, EAST CHICAGO, IN 46312-3078
(219) 397-8648
(219) 397-8653
Mailing address
9430 WICKER AVE, SAINT JOHN, IN 46373-9768
(219) 558-8068
(219) 558-8149
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
2001917
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000373304
ANTHEM
IN
05
—
036105846
—
IL
05
—
200184170D
—
IN
01
—
7538064
AETNA
IN
01
—
90001235
BCBS IL
IL
05
—
P00222849
—
IN
Enumeration date
07/06/2007
Last updated
11/15/2013
Update your record
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