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Organization
DEACONESS MEMORIAL MEDICAL CENTER INC
Active
Organization
DEACONESS MEMORIAL MEDICAL CENTER INC
Active
Other names
Deaconess Memorial Medical Center Inc, Memorial Hospital and HealthCare Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH MILLER (CAO & INDIANA REGION PRESIDENT)
(812) 996-0507
Entity
Organization
Contact information
Practice address
800 W 9TH STREET, JASPER, IN 47546-2514
(812) 482-0643
(812) 482-0214
Mailing address
800 W 9TH ST, JASPER, IN 47546-2514
(812) 996-1088
(812) 996-8497
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000097730
BLUE CROSS PROF FEE
IN
05
—
200265980A
—
IN
01
—
301557
BLACK LUNG
IN
Enumeration date
08/18/2006
Last updated
08/06/2026
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