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Organization
DEACONESS HOSPITAL, INC
Active
Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Care Group
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
600 MARY STREET, EVANSVILLE, IN 47747-0001
(812) 450-3036
(812) 450-2193
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-3036
(812) 450-2193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
2084N0400X
Neurology Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200153710A
—
IN
01
—
CG1119
RR MEDICARE GROUP #
IN
Enumeration date
06/05/2006
Last updated
03/04/2021
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