Organization
DEACONESS CLINIC, INC
Active
Other names
Deaconess Clinic I
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD M STIVERS (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
519 HARRIET ST, EVANSVILLE, IN 47710-1715
(812) 423-9699
(812) 434-2035
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RR0500X
Rheumatology Physician
—
—
Other
Enumeration date
08/12/2008
Last updated
11/04/2008
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