# DEACONESS MEMORIAL MEDICAL CENTER INC

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

## Provider details

- **NPI number:** 1235063058
- **Authorized official:** KEITH MILLER (CAO)
- **Authorized official phone:** (812) 996-0507

## Contact information

- **Practice address:** 507 E 19TH ST, HUNTINGBURG, IN 47542-9388
- **Practice address phone:** (812) 683-4717
- **Mailing address:** PO BOX 632641, CINCINNATI, OH 45263-2641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/09/2026
- **Last updated:** 06/09/2026