# DEACONESS SPECIALITY PHYSICIANS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124787973
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 1413 N ELM ST STE 106, HENDERSON, KY 42420-2776
- **Practice address phone:** (270) 831-7937
- **Practice address fax:** (270) 831-7939
- **Mailing address:** PO BOX 1230, EVANSVILLE, IN 47706-1230
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (812) 450-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/09/2021
- **Last updated:** 12/09/2021