# DEACONESS MEMORIAL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** DEACONESS MEMORIAL MEDICAL CENTER INC
- **Other names:** Crawford County Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1972877280
- **Legal business name:** DEACONESS MEMORIAL MEDICAL CENTER INC
- **Authorized official:** KEITH MILLER (CAO & INDIANA REGION PRESIDENT)
- **Authorized official phone:** (812) 996-0507

## Contact information

- **Practice address:** 6402 E INDUSTRIAL LANE, LEAVENWORTH, IN 47137-8316
- **Practice address phone:** (877) 291-6488
- **Mailing address:** P O BOX 1028, JASPER, IN 47547-1028
- **Mailing address phone:** (812) 996-8476
- **Mailing address fax:** (812) 996-8497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/05/2012
- **Last updated:** 08/27/2025