# DEACONESS SPECIALTY PHYSICIANS INC

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

## Provider details

- **NPI number:** 1154165462
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 8080 HIGH POINTE DR, NEWBURGH, IN 47630-3026
- **Practice address phone:** (812) 426-6678
- **Practice address fax:** (812) 450-8109
- **Mailing address:** PO BOX 632111, CINCINNATI, OH 45263-2111
- **Mailing address phone:** (812) 450-6879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/21/2024
- **Last updated:** 06/21/2024