# DEACONESS HOSPITAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Deaconess Medical Group Henderson I
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912175803
- **Authorized official:** RICHARD M STIVERS (SR VICE PRESIDENT, CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 1413 N ELM ST, STE 106, HENDERSON, KY 42420-2768
- **Practice address phone:** (270) 827-0064
- **Practice address fax:** (270) 826-3338
- **Mailing address:** PO BOX 3407, EVANSVILLE, IN 47733-3407
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (812) 450-6822

## Taxonomy

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

## Other

- **Enumeration date:** 02/14/2008
- **Last updated:** 02/14/2008