# DEACONESS CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Deaconess Clinic - Jasper Allergy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063211365
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 251 S TRUMAN RD, JASPER, IN 47546-9768
- **Practice address phone:** (812) 479-3153
- **Practice address fax:** (812) 473-8166
- **Mailing address:** PO BOX 3366, EVANSVILLE, IN 47732-3366
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (812) 450-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | — | NULL | Yes |
| 207K00000X | Allergy & Immunology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/10/2025
- **Last updated:** 03/10/2025