Organization
DEACONESS SPECIALTY PHYSICIANS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (SECRETARY/TREASURER)
(812) 450-3296
Entity
Organization
Contact information
Practice address
213 NW 10TH ST, FAIRFIELD, IL 62837
(812) 450-7899
(812) 450-6029
Mailing address
PO BOX 1230, EVANSVILLE, IN 47706-1230
(812) 450-7899
(812) 450-6029
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Enumeration date
02/27/2018
Last updated
05/15/2018
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