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Organization
DEACONESS SPECIALITY PHYSICIANS, INC
Active
Organization
DEACONESS SPECIALITY PHYSICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4209 GATEWAY BLVD, NEWBURGH, IN 47630-8900
(812) 492-5202
(812) 450-8102
Mailing address
PO BOX 1230, EVANSVILLE, IN 47706-1230
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/16/2021
Last updated
07/20/2021
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