# DEACONESS SPECIALITY PHYSICIANS, INC

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

## Provider details

- **NPI number:** 1942931498
- **Authorized official:** CHERYL ANNETTE WATHEN (SECRETARY/TREASURER)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 4011 GATEWAY BLVD, NEWBURGH, IN 47630-8947
- **Practice address phone:** (812) 450-6929
- **Mailing address:** PO BOX 1230, EVANSVILLE, IN 47706-1230
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (812) 450-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | — | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | Yes |
| 207XX0801X | Orthopaedic Trauma Physician | — | NULL | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/23/2022
- **Last updated:** 10/23/2025